Neuromuscular Blockade Monitoring in Acute Respiratory Distress Syndrome: Randomized Controlled Trial of Clinical Assessment Alone or With Peripheral Nerve Stimulation.

摘要: BACKGROUND Whether train-of-four (TOF) monitoring is more effective than clinical to guide neuromuscular blockade (NMB) in patients with acute respiratory distress syndrome (ARDS) unclear. We compared alone or TOF atracurium dosage adjustment respect drug dose and parameters. METHODS From 2015 2016, we conducted a randomized controlled trial comparing assessments every 2 hours without corrugator supercilii 4 who developed ARDS (Pao2/Fio2 <150 mm Hg) cardiothoracic intensive care unit. The primary outcome was the cumulative (mg/kg/h). Secondary outcomes included parameters during blockade. RESULTS A total of 38 + (C TOF) group 39 (C) were an intention-to-treat (ITT) analysis. higher C (1.06 [0.75-1.30] vs 0.65 [0.60-0.89] mg/kg/h group; P < .001) group, as well daily - mean difference = 0.256 [95% confidence interval {CI}, 0.099-0.416], .026). Driving pressures blocking agent (NMBA) administration did not differ between groups (P .653). Intensive unit (ICU) mortality 22% 27% .786). Days on ventilation 17 (8-26) 16 (10-35) group. CONCLUSIONS In ARDS, adding change ICU days mechanical (MV) but increase consumption when assessment alone. may be needed all receive for ARDS.