Critically evaluate the use of neuromuscular blocking agents in severe respiratory failure due to acute respiratory distress syndrome (ARDS).
Rationale & Theoretical Benefits
Anything reasonable – for example:
I do not use NMBs routinely in severe ARDS but in selected patients e.g. those difficult to ventilate / oxygenate I use cistracurium infusion with train of four monitoring
Papazian, Laurent, et al. "Neuromuscular blockers in early acute respiratory distress syndrome." N Engl J Med 363.12 (2010): 1107-1116.
Neto, Ary Serpa, et al. "Neuromuscular blocking agents in patients with acute respiratory distress syndrome: a summary of the current evidence from three randomized controlled trials." Annals of intensive care 2.1 (2012): 1-8.
National Heart, Lung, and Blood Institute PETAL Clinical Trials Network. "Early neuromuscular blockade in the acute respiratory distress syndrome." New England Journal of Medicine 380.21 (2019): 1997-2008.