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Neuromuscular Blocker May Help ARDS Patients

Increases survival without increasing weakness in severe acute respiratory distress syndrome

WEDNESDAY, Sept. 15 (HealthDay News) -- The early administration of a neuromuscular blocking agent appears to improve the odds of survival in patients with acute respiratory distress syndrome (ARDS) without resulting in increased muscle weakness, according to research published in the Sept. 16 issue of the New England Journal of Medicine.

Laurent Papazian, M.D., of the Université de la Méditerranée in Marseille, France, and colleagues randomly assigned 340 patients presenting to an intensive care unit with severe ARDS in the past 48 hours to either cisatracurium besylate (178 patients) or placebo (162 patients) for 48 hours.

Compared with the placebo group, the researchers found that the hazard ratio for death at 90 days was 0.68 in the cisatracurium group (P = 0.04). Crude 90-day mortality was 31.6 and 40.7 percent in the treatment group and placebo group, respectively, and 28-day mortality was 23.7 and 33.3 percent in the treatment group and placebo group, respectively (P = 0.08). At 28 days, mortality was 23.7 percent in the cisatracurium group and 33.3 percent in the placebo group (P = 0.05). No significant differences were seen between the two groups in regards to intensive care unit-acquired paresis.

"In patients with severe ARDS, early administration of a neuromuscular blocking agent improved the adjusted 90-day survival and increased the time off the ventilator without increasing muscle weakness," the authors write.

GlaxoSmithKline provided the drugs for the study.

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