What is the clinical effectiveness of neuromuscular blocking agents during mechanical ventilation of patients with acute respiratory distress syndrome?
What are the evidence-based guidelines regarding the use of neuromuscular blocking agents during mechanical ventilation of patients with acute respiratory distress syndrome?
Neuromuscular blocking agents may be beneficial in patients with moderate and severe acute respiratory distress syndrome. One systematic review found that using neuromuscular blocking agents is associated with lower mortality, while one randomized controlled trial did not find a significant difference in effectiveness and was stopped early due to futility. One non-randomized study did not find a difference in effectiveness between cisatracurium and atracurium, while another study found cisatracurium was more effective than vecuronium. Guidelines generally had had weakly favourable recommendations for the use of neuromuscular blocking agents in early moderate to severe acute respiratory distress patients, based on a moderate quality of evidence.