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01-12-2020 | Acute Respiratory Distress-Syndrome | Review

Myorelaxants in ARDS patients

Authors: Sami Hraiech, Takeshi Yoshida, Djillali Annane, Abhijit Duggal, Vito Fanelli, Arnaud Gacouin, Leo Heunks, Samir Jaber, Peter D. Sottile, Laurent Papazian

Published in: Intensive Care Medicine | Issue 12/2020

Abstract

Neuromuscular blocking agents (NMBAs) inhibit patient-initiated active breath and the risk of high tidal volumes and consequent high transpulmonary pressure swings, and minimize patient/ ventilator asynchrony in acute respiratory distress syndrome (ARDS). Minimization of volutrauma and ventilator-induced lung injury (VILI) results in a lower incidence of barotrauma, improved oxygenation and a decrease in circulating proinflammatory markers. Recent randomized clinical trials did not reveal harmful muscular effects during a short course of NMBAs. The use of NMBAs should be considered during the early phase of severe ARDS for patients to facilitate lung protective ventilation or prone positioning only after optimising mechanical ventilation and sedation. The use of NMBAs should be integrated in a global strategy including the reduction of tidal volume, the rational use of PEEP, prone positioning and the use of a ventilatory mode allowing spontaneous ventilation as soon as possible. Partial neuromuscular blockade should be evaluated in future trials.

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Title: Myorelaxants in ARDS patients
Authors: Sami Hraiech
Takeshi Yoshida
Djillali Annane
Abhijit Duggal
Vito Fanelli
Arnaud Gacouin
Leo Heunks
Samir Jaber
Peter D. Sottile
Laurent Papazian
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Acute Respiratory Distress-Syndrome
ECMO
ECMO
Cisatracurium
Published in: Intensive Care Medicine / Issue 12/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-020-06297-8

At a glance: The STEP trials

Springer Medicine

Myorelaxants in ARDS patients

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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