Evidence map›Paper›PMID 35581612›Full record

ArticleCritical care (London, England)2022

Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis.

Gianluigi Li Bassi, Kristen Gibbons, Jacky Y Suen, Heidi J Dalton, Nicole White, Amanda Corley, Sally Shrapnel, Samuel Hinton, Simon Forsyth, John G Laffey and 23 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.0field-weighted citation impact, top 7% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 21 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors at 20 institutions in 48 countries.

Gianluigi Li Bassi *Critical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, Brisbane, QLD, 4032, Australia. g.libassi@uq.edu.au.ORCID 0000-0002-0816-0880
Kristen Gibbons *Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Jacky Y SuenCritical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, Brisbane, QLD, 4032, Australia.
Heidi J DaltonINOVA Fairfax Medical Center, Heart and Vascular Institute, Falls Church, VA, USA.
Nicole WhiteQueensland University of Technology, Brisbane, Australia.
Amanda CorleyCritical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, Brisbane, QLD, 4032, Australia.
Sally ShrapnelUniversity of Queensland, Brisbane, Australia.
Samuel HintonUniversity of Queensland, Brisbane, Australia.
Simon ForsythUniversity of Queensland, Brisbane, Australia.
John G LaffeyAnaesthesia and Intensive Care Medicine, School of Medicine, National University of Ireland, and Galway University Hospitals, Galway, Ireland.
Eddy FanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
Jonathon P FanningCritical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, Brisbane, QLD, 4032, Australia.
Mauro PanigadaFondazione IRCCS Ca Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
Robert BartlettUniversity of Michigan Medical Center, Ann Arbor, MI, USA.
Daniel BrodieDepartment of Medicine, Columbia College of Physicians and Surgeons, and Center for Acute Respiratory Failure, New-York-Presbyterian Hospital, New York, NY, USA.
Aidan BurrellAustralian and New Zealand Intensive Care Research Centre, School of Public Health, Monash University, Melbourne, Australia.
Davide ChiumelloOspedale San Paolo, Milan, Italy.
Alyaa ElhazmiKing Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Mariano EsperattiHospital Privado de Comunidad, Escuela de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina.
Giacomo GrasselliInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
Carol HodgsonAustralian and New Zealand Intensive Care Research Centre, School of Public Health, Monash University, Melbourne, Australia.
Shingo IchibaNippon Medical School Hospital, Tokyo, Japan.
Carlos LunaNeumonología, Hospital de Clínicas, UBA, Buenos Aires, Argentina.
Eva MarwaliNational Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
Laura MersonISARIC, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Srinivas MurthyDepartment of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Alistair NicholAustralian and New Zealand Intensive Care Research Centre, School of Public Health, Monash University, Melbourne, Australia.
Mark OginoNemours Alfred I duPont Hospital for Children, Wilmington, DE, USA.
Paolo PelosiDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
Antoni TorresInstitut dInvestigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
Pauline Yeung NgDepartment of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
John F FraserCritical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, Brisbane, QLD, 4032, Australia.
COVID-19 Critical Care Consortium
Clinical Research Consortium · USThe University of Queensland · AUFroedtert Hospital · USMain Line Health · USThe Ohio State University · USClínica Las Condes · CLHamad General Hospital · QAHospital of the University of Pennsylvania · USIstituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione · ITGroote Schuur Hospital · ZARush University · USUniversity of California, San Francisco · USBaylor Scott & White Health · USCleveland Clinic · USFatmawati Hospital · IDFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico · ITLancaster General Hospital · USNational Brain Centre · IDNorth Estonia Medical Centre · EEQueensland University of Technology · AU

Funding

Bill and Melinda Gates Foundation INV-034765
6 · The paper itself

Abstract

backgroundThe role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis.

methodsWe analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression.

resultsData from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0-25) and 25 (IQR 7-26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0-87) and 87 (IQR 0-88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177).

conclusionsIn patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting.

Indexed as

COVID-19 Drug TreatmentNeuromuscular Blocking AgentsRespiratory Distress SyndromeAgedFemaleHumansIntensive Care UnitsMaleMiddle AgedPropensity ScoreRespiration, ArtificialNeuromuscular Blocking AgentsCOVID-19Intensive care unitMechanical ventilationNeuromuscular blocking agentSARS-CoV-2

Identifiers

PMID35581612
PMCPMC9112652
OpenAlexW4280567781

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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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.