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NMB's ards survival benefit

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By Jason Mann No BS pulmonary critical care fellow
Sami Hraiech, Takeshi Yoshida, Laurent Papazian
PURPOSE OF REVIEW: Acute respiratory distress syndrome (ARDS) is still associated with a high mortality. The best way to ensure mechanical ventilation in ARDS patients is still debated, recent data arguing for a muscle paralysis and a controlled ventilation whereas other elements being in favor of a preserved spontaneous breathing. The purpose of this review is to discuss the benefits and the disadvantages of both strategies. RECENT FINDINGS: Randomized controlled trials have brought the evidence that at the acute phase of ARDS, a 48-h administration of cisatracurium is associated with a decrease in mortality for the most severe hypoxemic patients...
February 2015: Current Opinion in Critical Care
Laurent Papazian, Jean-Marie Forel, Arnaud Gacouin, Christine Penot-Ragon, Gilles Perrin, Anderson Loundou, Samir Jaber, Jean-Michel Arnal, Didier Perez, Jean-Marie Seghboyan, Jean-Michel Constantin, Pierre Courant, Jean-Yves Lefrant, Claude Guérin, Gwenaël Prat, Sophie Morange, Antoine Roch et al.
BACKGROUND: In patients undergoing mechanical ventilation for the acute respiratory distress syndrome (ARDS), neuromuscular blocking agents may improve oxygenation and decrease ventilator-induced lung injury but may also cause muscle weakness. We evaluated clinical outcomes after 2 days of therapy with neuromuscular blocking agents in patients with early, severe ARDS. METHODS: In this multicenter, double-blind trial, 340 patients presenting to the intensive care unit (ICU) with an onset of severe ARDS within the previous 48 hours were randomly assigned to receive, for 48 hours, either cisatracurium besylate (178 patients) or placebo (162 patients)...
September 16, 2010: New England Journal of Medicine
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