Effect of Different Depths of Neuromuscular Blockade on Respiratory Mechanics in Patients With Moderate-severe Acute Respiratory Distress Syndrome

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Acute respiratory distress syndrome (ARDS) is characterized by acute diffuse alveolar injury caused by a variety of pulmonary and extrapulmonary factors, leading to refractory hypoxemia. It has high incidence and mortality rates. Neuromuscular blocking agents (NMBAs) play a crucial role as adjunctive therapy for ARDS, aiding in lung-protective ventilation by inhibiting excessive spontaneous breathing, improving patient-ventilator synchrony, and reducing barotrauma. Determining the appropriate depth of muscle relaxation in moderate to severe ARDS patients receiving NMBAs remains a clinical challenge. Research has shown that partial neuromuscular blockade is feasible in certain ARDS patients. However, large randomized controlled trials (RCTs) and clinical practices often use higher doses of NMBAs to ensure complete cessation of spontaneous breathing. This indicates an ongoing debate regarding the optimal depth of neuromuscular blockade necessary for lung-protective ventilation in ARDS patients. It also raises the question of whether the optimal depth of neuromuscular blockade varies among patients with different severities of ARDS. This study aims to investigate changes in respiratory mechanics and other physiological parameters in moderate to severe ARDS patients under different depths of neuromuscular blockade. The investigators will evaluate the impact of targeted neuromuscular blockade depth on lung protection in these patients.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18 days
Maximum Age: 85
Healthy Volunteers: f
View:

• Patients with moderate to severe ARDS requiring the use of NMBAs, as assessed by clinicians (Berlin definition 2012: PaO2/FiO2 \< 150 mmHg, PEEP ≥ 5).

• Age: 18-85 years.

• Signed informed consent.

Locations
Other Locations
China
Zhongda Hospital, Affiliated to Southeast University
RECRUITING
Nanjing
Contact Information
Primary
Lihong Xu
220223899@seu.edu.cn
+86 18551696812
Time Frame
Start Date: 2024-06-28
Estimated Completion Date: 2025-06-30
Participants
Target number of participants: 20
Treatments
Experimental: Moderate-Severe ARDS patients
The dose of cisatracurium was gradually adjusted to achieve different depth of muscle relaxation
Sponsors
Leads: Southeast University, China

This content was sourced from clinicaltrials.gov