Patients suffering from acute respiratory distress syndrome (ARDS) being treated with mechanical ventillation may be benefited by administering neuromuscular blocking agents (NMBA) to improve perfusion and reduce risk of lung injury.

Paralyzing the breathing muscles decreases the forces resisting autonomic respiration and allows for mechanical ventilators to more easily induce respiration in patients. Cisatracurium, a nondepolarizing neuromuscular agent, competitively inhibits post synaptic acetylcholine receptors of the neuromuscular plate, paralyzing the breathing muscles. 

The authors found that early administration of cistracurium to patients with severe ARDS improves the 90-day mortality rate and increases time off ventilator without increasing muscle weakness.

This trial challenges current paradigms that lighter sedation without paralytic agents improve outcomes of ARDS. Administering NMBAs shows the beneficial outcomes for patients suffering from ARDS.

http://ccforum.com/content/15/5/311 

Gabe Swords

Sara Sun

Sara Taege

Emily Tillmaand

Armin Tadayyon