Reevaluation Of Systemic Early Neuromuscular Blockade
Trial ID or NCT#
Status
Purpose
This study evaluates whether giving a neuromuscular blocker (skeletal muscle relaxant) to a patient with acute respiratory distress syndrome will improve survival. Half of the patients will receive a neuromuscular blocker for two days and in the other half the use of neuromuscular blockers will be discouraged.
Official Title
Reevaluation Of Systemic Early Neuromuscular Blockade
Eligibility Criteria
- 1. Lack of informed consent 2. Continuous neuromuscular blockade at enrollment 3. Known pregnancy 4. Currently receiving ECMO therapy 5. Chronic respiratory failure defined as PaCO2 > 60 mm Hg in the outpatient setting 6. Home mechanical ventilation (non-invasive ventilation or via tracheotomy) except for CPAP/BIPAP used solely for sleep-disordered breathing 7. Actual body weight exceeding 1 kg per centimeter of height 8. Severe chronic liver disease defined as a Child-Pugh score of 12-15 (Appendix A2) 9. Bone marrow transplantation within the last 1 year 10. Expected duration of mechanical ventilation of < 48 hours 11. Decision to withhold life-sustaining treatment; except in those patients committed to full support except cardiopulmonary resuscitation if an actual cardiac arrest occurs 12. Moribund patient not expected to survive 24 hours; if CPR provided, assess for moribund status greater than 6 from CPR conclusion 13. Diffuse alveolar hemorrhage from vasculitis 14. Burns > 70% total body surface 15. Unwillingness to utilize the ARDS Network 6 ml/kg IBW ventilation protocol 16. Previous hypersensitivity or anaphylactic reaction to cisatracurium 17. Neuromuscular conditions that may potentiate neuromuscular blockade and/or impair spontaneous ventilation (Appendix A2) 18. Neurologic conditions undergoing treatment for intracranial hypertension 19. Enrollment in an interventional ARDS trial with direct impact on neuromuscular blockade and PEEP 20. >120 hours of mechanical ventilation 21. P/F < 200 mmHg at the time of randomization (if available)
Investigator(s)
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Contact
SPECTRUM
6507236576
View on ClinicalTrials.gov