Abstract | INTRODUCTION: METHODS: We conducted a systematic review and meta-analysis. We searched the Cochrane (Central) database, MEDLINE, EMBASE, ACP Journal Club, and clinical trial registries for randomized trials investigating survival effects of neuromuscular blocking agents in adults with ARDS. Two independent reviewers abstracted data and assessed methodologic quality. Primary study investigators provided additional unpublished data. RESULTS: Three trials (431 patients; 20 centers; all from the same research group in France) met inclusion criteria for this review. All trials assessed 48-hour infusions of cisatracurium besylate. Short-term infusion of cisatracurium besylate was associated with lower hospital mortality (RR, 0.72; 95% CI, 0.58 to 0.91; P=0.005; I2=0). This finding was robust on sensitivity analyses. Neuromuscular blockade was also associated with lower risk of barotrauma (RR, 0.43; 95% CI, 0.20 to 0.90; P=0.02; I2=0), but had no effect on the duration of mechanical ventilation among survivors (MD, 0.25 days; 95% CI, 5.48 to 5.99; P=0.93; I2=49%), or the risk of ICU-acquired weakness (RR, 1.08; 95% CI, 0.83 to 1.41; P=0.57; I2=0). Primary studies lacked protracted measurements of weakness. CONCLUSIONS:
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Authors | Waleed Alhazzani, Mohamed Alshahrani, Roman Jaeschke, Jean Marie Forel, Laurent Papazian, Jonathan Sevransky, Maureen O Meade |
Journal | Critical care (London, England)
(Crit Care)
Vol. 17
Issue 2
Pg. R43
(Mar 11 2013)
ISSN: 1466-609X [Electronic] England |
PMID | 23497608
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Neuromuscular Blocking Agents
- Atracurium
- cisatracurium
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Topics |
- Atracurium
(analogs & derivatives, therapeutic use)
- Humans
- Neuromuscular Blocking Agents
(therapeutic use)
- Randomized Controlled Trials as Topic
(methods)
- Respiration, Artificial
(methods)
- Respiratory Distress Syndrome
(diagnosis, epidemiology, therapy)
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