The patient is admitted to intensive care where worsening hypoxia means she is intubated and ventilated. You spend time ensuring that her ventilation is optimised appropriately. The nurse asks what else should be...
Mechanisms remain unclear but thought to be due to: Reduced patient-ventilator dyssynchrony Improved chest wall compliance resulting in reduced driving pressures Anti-inflammatory effect Not established whether these are limited to (cis-) atracurium or wider NMB...
RCT: ACURASYSPapazian et al NEJM (2010)View Paper RCT: ROSEARDSNet NEJM (2019)View Paper Intervention Cisatracurium vs. placebo for 48 hours Cisatracurium vs. placebo for 48 hours Population 348 patients with severe ARDS (P/F ratio <13 kPa) 1006 patients with...
FICM / ICSView Guideline Recommendation Not recommended for use in all patients with ARDS. Suggest cisatracurium infusion for 48 hours in patients with moderate/severe ARDS with P/F ratio <20 kPa. (Weak recommendation) Related...
