Evidence map›Paper›PMID 26540149›Full record

ArticleAnesthesiology2016

Neuromuscular Blocking Agent Cisatracurium Attenuates Lung Injury by Inhibition of Nicotinic Acetylcholine Receptor-α1.

Vito Fanelli, Yasumasa Morita, Paola Cappello, Mirna Ghazarian, Bina Sugumar, Luisa Delsedime, Jane Batt, V Marco Ranieri, Haibo Zhang, Arthur S Slutsky

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Anesthesiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04996394 (Effects of Neuromuscular Blocking Agents on End Expiratory Lung Volume During Moderate-severe ARDS), which is not on this map. Cited by 38 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 4 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04996394 completednot on this mapstarted 2019, after this paper: background citation

Effects of Neuromuscular Blocking Agents on End Expiratory Lung Volume During Moderate-severe ARDS

TypeobservationalSponsorUniversity of Milano BicoccaRan2019 to 2020Enrolled15ConditionsARDS, Neuromuscular Blockade
3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Exploring pharmacological strategies in the management of ARDS: Efficacy, limitations, and future directions.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025
    Review
  8. Review
  9. Advances in anti-inflammatory treatment of sepsis-associated acute respiratory distress syndrome.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025
    Review
  10. Review
  11. Treatment Mechanism and Inflammatory Subphenotyping in Acute Respiratory Distress Syndrome.American journal of respiratory and critical care medicine · 2024
    Article
  12. Article
  13. Article
  14. Review
  15. Review
  16. Review
  17. Antagonist of Chrna1 prevents the pathogenesis of primary focal hyperhidrosis.Annals of clinical and translational neurology · 2022
    Article
  18. Review
  19. Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Vito FanelliFrom the Department of Anesthesia and Critical Care, University of Turin, AOU Città della Salute e della Scienza di Torino - Ospedale Molinette, Torino, Italy (V.F., V.M.R.); Critical Care Program, The Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada (Y.M., M.G., B.S., J.B., H.Z., A.S.S.); Department of Molecular Biotechnologies and Health Sciences, University of Turin, Turin, Italy (P.C.); Department of Pathology, AOU Città della Salute e della Scienza di Torino - Ospedale Molinette, Torino, Italy (L.D.); Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada (H.Z., A.S.S.); and Departments of Anesthesia and Physiology, University of Toronto, Toronto, Ontario, Canada (H.Z.).
Yasumasa Morita
Paola Cappello
Mirna Ghazarian
Bina Sugumar
Luisa Delsedime
Jane Batt
V Marco Ranieri
Haibo Zhang
Arthur S Slutsky
University of Turin · ITSt. Michael's Hospital · CA

Funding

Canadian Institutes of Health Research MOP 102486Canadian Institutes of Health Research MOP 69042Canadian Institutes of Health Research MOP 77818
6 · The paper itself

Abstract

backgroundNeuromuscular blocking agents (NMBAs) bind the nicotinic acetylcholine receptor α1 (nAChRα1) that also contributes to inflammatory signaling. Thus, the author hypothesized that the use of NMBA mitigates lung injury by improving ventilator synchrony and decreasing inflammatory responses.

methodsLung injury was induced by intratracheal instillation of hydrogen chloride in rats that were randomized to receive no NMBA with evidence of asynchronous ventilation (noNMBA/aSYNC, n = 10); no NMBA with synchronous ventilation (noNMBA/SYNC, n = 10); cisatracurium (CIS, n = 10); or pancuronium (PAN, n = 10). Mechanical ventilation was set at a tidal volume of 6 ml/kg and positive end-expiratory pressure 8 cm H2O for 3 h. Human lung epithelial, endothelial, and CD14⁺ cells were challenged with mechanical stretch, lipopolysaccharide, lung lavage fluids (bronchoalveolar lavage fluid), or plasma obtained from patients (n = 5) with acute respiratory distress syndrome, in the presence or absence of CIS or small-interfering RNA and small hairpin RNA to attenuate the cell expression of nAChRα1.

resultsThe use of CIS and PAN improved respiratory compliance (7.2 ± 0.7 in noNMBA/aSYNC, 6.6 ± 0.5 in noNMBA/SYNC, 5.9 ± 0.3 in CIS, and 5.8 ± 0.4 cm H2O/l in PAN; P < 0.05), increased PaO2 (140 ± 54, 209 ± 46, 269 ± 31, and 269 ± 54 mmHg, respectively, P < 0.05), and decreased the plasma levels of tumor necrosis factor-α (509 ± 252 in noNMBA, 200 ± 74 in CIS, and 175 ± 84 pg/ml in PAN; P < 0.05) and interleukin-6 (5789 ± 79, 1608 ± 534, and 2290 ± 315 pg/ml, respectively; P < 0.05). The use of CIS and PAN or silencing the receptor nAChRα1 resulted in decreased cytokine release in the human cells in response to a variety of stimuli mentioned earlier.

conclusionsThe use of NMBA is lung protective through its antiinflammatory properties by blocking the nAChRα1.

Indexed as

Analysis of VarianceAnimalsAtracuriumDisease Models, AnimalInflammationLung InjuryMaleMiceMice, Inbred C57BLNeuromuscular Blocking AgentsRatsRats, Sprague-DawleyReceptors, NicotinicAtracuriumcisatracuriumNeuromuscular Blocking AgentsReceptors, Nicotinic

Identifiers

PMID26540149
OpenAlexW2197803486

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.