SynthesisCritical care (London, England)2020
Validation of neuromuscular blocking agent use in acute respiratory distress syndrome: a meta-analysis of randomized trials.
Synthesis in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis 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
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Heterogenous treatment effect of neuromuscular blocking agents for moderate-to-severe ARDS: a post hoc Markov model re-analysis of the ACURASYS trial.Intensive care medicine · 2025Trial
- Management of Neuromuscular Blocking Agents in Critically Ill Patients with Lung Diseases.Journal of clinical medicine · 2024Review
- Risk factors for prolonged mechanical ventilation in critically ill patients with influenza-related acute respiratory distress syndrome.Respiratory research · 2024Article
- Prognostic value of oxygen saturation index trajectory phenotypes on ICU mortality in mechanically ventilated patients: a multi-database retrospective cohort study.Journal of intensive care · 2023Article
- Atracurium Versus Cisatracurium in the Treatment of Acute Respiratory Distress Syndrome.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2023Article
- Biphasic positive airway pressure spontaneous breathing attenuates lung injury in an animal model of severe acute respiratory distress syndrome.BMC anesthesiology · 2022Article
- Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis.Critical care (London, England) · 2022Article
- Observational
- Neuromuscular blocking drugs in the critically ill.BJA education · 2021Review
- The Implementation of Protocol-Based Utilization of Neuromuscular Blocking Agent Using Clinical Variables in Acute Respiratory Distress Syndrome Patients.Critical care explorations · 2021Article
- Myorelaxants in ARDS patients.Intensive care medicine · 2020Review
- Neuromuscular blocking agents in acute respiratory distress syndrome: updated systematic review and meta-analysis of randomized trials.Intensive care medicine experimental · 2020Review
- The use of a neuromuscular blocking agent could significantly decrease mortality in moderate-to-severe ARDS patients: is moderate ARDS the best indication for neuromuscular blocking agents.Critical care (London, England) · 2020Article
- Risk Factors for Patient-Ventilator Asynchrony and Its Impact on Clinical Outcomes: Analytics Based on Deep Learning Algorithm.Frontiers in medicine · 2020Article
- Article
- Neuromuscular blockade management in the critically Ill patient.Journal of intensive care · 2020Review
- Predictive factors and clinical impact of ICU-acquired weakness on functional disability in mechanically ventilated patients with COVID-19.Heart & lung : the journal of critical careObservational
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
Abstract
backgroundWe aimed to synthesize up-to-date trials to validate the effects of neuromuscular blocking agent (NMBA) use in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).
methodsSeveral databases including PubMed, EMBASE, Web of Science, and Cochrane Central Register were searched up to November 14, 2019. All randomized trials investigating the use of NMBAs in patients with moderate-to-severe ARDS and reporting mortality data were included in the meta-analysis. The primary outcome was mortality, and the secondary outcomes were clinical outcomes, including respiratory physiological parameters, incidence of barotrauma, ICU-free days, and ventilation-free days.
resultsA total of 7 trials enrolling 1598 patients were finally included in this meta-analysis. The results revealed that the use of NMBAs in moderate-to-severe ARDS could significantly decrease the mortality truncated to day 28 (RR 0.74, 95% CI 0.56 to 0.98, P = 0.03) and day 90 (RR 0.77, 95% CI 0.60 to 0.99, P = 0.04). NMBA use could significantly decrease the incidence of barotrauma (RR 0.56, 95% CI 0.36 to 0.87, P = 0.009). No significant difference was observed in ICU-free days or ventilation-free days between the NMBA and control groups.
conclusionThe use of NMBAs could significantly decrease mortality in moderate-to-severe ARDS patients and decrease the incidence of barotrauma during mechanical ventilation. However, more large-scale randomized trials are needed to further validate the effect of NMBA use in 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.