Acute Respiratory Distress Syndrome Clinical Trial
Official title:
Reevaluation Of Systemic Early Neuromuscular Blockade
This study evaluates whether giving a neuromuscular blocker (skeletal muscle relaxant) to a patient with acute respiratory distress syndrome will improve survival. Half of the patients will receive a neuromuscular blocker for two days and in the other half the use of neuromuscular blockers will be discouraged.
PRIMARY OBJECTIVE:
To assess the efficacy and safety of early neuromuscular blockade in reducing mortality and
morbidity in patients with moderate-severe ARDS, in comparison to a control group with no
routine early neuromuscular blockade (NMB).
PRIMARY HYPOTHESIS:
Early neuromuscular blockade will improve mortality prior to discharge home before day 90, in
patients with moderate-severe ARDS.
The trial will accrue a maximum of 1408 patients. Patients will be recruited from the
emergency departments, intensive care units and other acute care areas of the PETAL Network
Clinical Centers and randomized to the active (NMB) or control. The overall strategy is to
screen, consent, and enroll early, every newly intubated, acutely ill or post-operative,
eligible patient at each site, using clinically obtained pulse oximetry and blood gases.
By preventing active expiration, and/or patient ventilator dyssynchrony, neuromuscular
blockade may create a more homogenous distribution of airway pressures and tidal volumes,
preventing barotrauma/volutrauma and "atelectrauma" resulting in less ventilator-induced lung
injury.
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