A Survey of Academic Intensivists' Use of Neuromuscular Blockade in Subjects With ARDS.
ACURASYS trial
acute respiratory distress syndrome
intensivist
lung-protective ventilation
mechanical ventilation
neuromuscular blockade
survey
Journal
Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
pubmed:
12
9
2019
medline:
29
12
2020
entrez:
12
9
2019
Statut:
ppublish
Résumé
Our Cooling to Help Injured Lungs (CHILL) trial of therapeutic hypothermia in ARDS includes neuromuscular blockade (NMB) as an inclusion criterion to avoid shivering. NMB has been used to facilitate mechanical ventilation in ARDS and was shown to reduce mortality in the ACURASYS trial. To assess the feasibility of a multi-center CHILL trial, we conducted a survey of academic intensivists about their NMB use in patients with ARDS. We distributed via email a 16-question survey about NMB use in patients with ARDS including frequency, indications, and dosing strategy. 212 (24.3%) of 871 respondents completed the survey: 94.7% were board-certified in internal medicine, 88% in pulmonary and critical care; 90.3% practiced in academic medical centers, with 87% working in medical ICUs; 96.6% of respondents who treat ARDS use NMB, and 39.7% use NMB in ≥ 50% of these patients. Of 4 listed indications for initiating NMB in ARDS, allowing adherence with lung-protective ventilator strategies and patient-ventilator synchrony were cited as the most important reasons, followed by the results of the ACURASYS trial and facilitating prone positioning. We conclude that NMB is frequently used by academic intensivists to facilitate mechanical ventilation in patients with moderate to severe ARDS.
Sections du résumé
BACKGROUND
BACKGROUND
Our Cooling to Help Injured Lungs (CHILL) trial of therapeutic hypothermia in ARDS includes neuromuscular blockade (NMB) as an inclusion criterion to avoid shivering. NMB has been used to facilitate mechanical ventilation in ARDS and was shown to reduce mortality in the ACURASYS trial. To assess the feasibility of a multi-center CHILL trial, we conducted a survey of academic intensivists about their NMB use in patients with ARDS.
METHODS
METHODS
We distributed via email a 16-question survey about NMB use in patients with ARDS including frequency, indications, and dosing strategy.
RESULTS
RESULTS
212 (24.3%) of 871 respondents completed the survey: 94.7% were board-certified in internal medicine, 88% in pulmonary and critical care; 90.3% practiced in academic medical centers, with 87% working in medical ICUs; 96.6% of respondents who treat ARDS use NMB, and 39.7% use NMB in ≥ 50% of these patients. Of 4 listed indications for initiating NMB in ARDS, allowing adherence with lung-protective ventilator strategies and patient-ventilator synchrony were cited as the most important reasons, followed by the results of the ACURASYS trial and facilitating prone positioning.
CONCLUSIONS
CONCLUSIONS
We conclude that NMB is frequently used by academic intensivists to facilitate mechanical ventilation in patients with moderate to severe ARDS.
Identifiants
pubmed: 31506341
pii: respcare.07026
doi: 10.4187/respcare.07026
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
362-368Informations de copyright
Copyright © 2020 by Daedalus Enterprises.
Déclaration de conflit d'intérêts
The authors have disclosed no conflicts of interest.