Observational studyAmerican journal of respiratory and critical care medicine2018
An Observational Study of the Efficacy of Cisatracurium Compared with Vecuronium in Patients with or at Risk for Acute Respiratory Distress Syndrome.
Observational study in American journal of respiratory and critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Reducing the dose of neuromuscular blocking agents with adjuncts: a systematic review and meta-analysis.British journal of anaesthesia · 2021Pooled it
- Neuromuscular blocking agents for acute respiratory distress syndrome: an updated meta-analysis of randomized controlled trials.Respiratory research · 2020Pooled it
- Pooled it
- The Use of Cisatracurium in Cardiac Surgery.Turkish journal of anaesthesiology and reanimation · 2025Article
- Developing A Data Pipeline to Quantify Ventilator Waveforms.medRxiv : the preprint server for health sciences · 2025Article
- Sedation Practices during Continuous Neuromuscular Blockade for Acute Respiratory Distress Syndrome.Annals of the American Thoracic Society · 2025Article
- 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) · 2025Review
- Analgesia and Sedation Use During Noninvasive Ventilation for Acute Respiratory Failure.Critical care medicine · 2024Article
- Association between Substance Misuse and Outcomes in Critically III Patients with Pneumonia.Annals of the American Thoracic Society · 2023Article
- Physiological and clinical variables identify ARDS classes and therapeutic heterogeneity to glucocorticoids: a retrospective study.BMC pulmonary medicine · 2023Article
- Extracorporeal Membrane Oxygenation for Refractory Asthma Exacerbations With Respiratory Failure.Chest · 2023Observational
- Neuromuscular Blockade in the Pre- and COVID-19 ARDS Patients.Journal of personalized medicine · 2022Review
- Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis.Critical care (London, England) · 2022Article
- Continuously protracted infusion of cisatracurium besilate in patients with ARDS.Annals of medicine and surgery (2012) · 2022Article
- Pharmacologic Treatments for Acute Respiratory Distress Syndrome.Critical care clinics · 2021Review
- [Simultaneous determination of three quaternary ammonium muscle relaxants in blood by high performance liquid chromatography-tandem mass spectrometry].Se pu = Chinese journal of chromatography · 2021Article
- Comparative Efficacy of Fentanyl and Morphine in Patients with or At Risk for Acute Respiratory Distress Syndrome: A Propensity Score-Matched Cohort Study.Drugs in R&D · 2021Article
- Comparative Effectiveness of Midazolam, Propofol, and Dexmedetomidine in Patients With or at Risk for Acute Respiratory Distress Syndrome: A Propensity Score-Matched Cohort Study.Frontiers in pharmacology · 2021Article
- Noninvasive Ventilation Use in Critically Ill Patients with Acute Asthma Exacerbations.American journal of respiratory and critical care medicine · 2020Article
- Myorelaxants in ARDS patients.Intensive care medicine · 2020Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
rationaleThe neuromuscular blocking agent cisatracurium may improve mortality for patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Other neuromuscular blocking agents, such as vecuronium, are commonly used and have different mechanisms of action, side effects, cost, and availability in the setting of drug shortages.
objectivesTo determine whether cisatracurium is associated with improved outcomes when compared with vecuronium in patients at risk for and with ARDS.
methodsUsing a nationally representative database, patients who were admitted to the ICU with a diagnosis of ARDS or an ARDS risk factor, received mechanical ventilation, and were treated with a continuous infusion of neuromuscular blocking agent for at least 2 days within 2 days of hospital admission were included. Patients were stratified into two groups: those who received cisatracurium or vecuronium. Propensity matching was used to balance both patient- and hospital-specific factors. Outcomes included hospital mortality, duration of mechanical ventilation, ICU and hospital duration, and discharge location. MEASUREMENTS AND MAIN
resultsPropensity matching successfully balanced all covariates for 3,802 patients (1,901 per group). There was no significant difference in mortality (odds ratio, 0.932; P = 0.40) or hospital days (-0.66 d; P = 0.411) between groups. However, patients treated with cisatracurium had fewer ventilator days (-1.01 d; P = 0.005) and ICU days (-0.98 d; P = 0.028) but were equally likely to be discharged home (odds ratio, 1.19; P = 0.056).
conclusionsWhen compared with vecuronium, cisatracurium was not associated with a difference in mortality but was associated with improvements in other clinically important outcomes. These data suggest that cisatracurium may be the preferred neuromuscular blocking agent for patients at risk for and with ARDS.
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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.