Role of Pharmacologic Paralysis in Acute Respiratory Distress Syndrome

Ammar Syed; Alexander Kobzik; David T. Huang

doi:10.1055/s-0039-1683883

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2019; 40(01): 101-113
DOI: 10.1055/s-0039-1683883

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Pharmacologic Paralysis in Acute Respiratory Distress Syndrome

Ammar Syed

¹Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

,

Alexander Kobzik

¹Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

,

David T. Huang

¹Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

²Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

³The MACRO Center (Multidisciplinary Acute Care Research Organization), University of Pittsburgh, Pittsburgh, Pennsylvania

⁴The CRISMA Center (Clinical Research, Investigation, and Systems Modeling of Acute Illness), University of Pittsburgh, Pittsburgh, Pennsylvania

› Institutsangaben

Abstract

The pharmacology and history of neuromuscular blockade in clinical care are complex, with multiple theoretical and observed potential benefits and potential harms. Past studies raised concern for long-term paresis, but more recent studies have not found evidence for harm, possibly due to changes in background care, neuromuscular blocking agent, and duration of blockade. Current use is highly variable, likely due to limited evidence for efficacy beyond short-term physiologic improvement and lingering concerns for harm. A recently completed large multicenter trial will provide further information on the role of pharmacologic paralysis in acute respiratory distress syndrome.

Keywords

neuromuscular blocking agents - pharmacologic paralysis - neuromuscular blockade - acute respiratory distress syndrome - clinical trial

Volltext

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References
1 deBacker J, Hart N, Fan E. Neuromuscular blockade in the 21st century management of the critically ill patient. Chest 2017; 151 (03) 697-706
2 Greenberg SB, Vender J. The use of neuromuscular blocking agents in the ICU: where are we now?. Crit Care Med 2013; 41 (05) 1332-1344
3 Warr J, Thiboutot Z, Rose L, Mehta S, Burry LD. Current therapeutic uses, pharmacology, and clinical considerations of neuromuscular blocking agents for critically ill adults. Ann Pharmacother 2011; 45 (09) 1116-1126
4 Jonsson M, Dabrowski M, Gurley DA. , et al. Activation and inhibition of human muscular and neuronal nicotinic acetylcholine receptors by succinylcholine. Anesthesiology 2006; 104 (04) 724-733
5 Martyn JAJ, Richtsfeld M. Succinylcholine-induced hyperkalemia in acquired pathologic states: etiologic factors and molecular mechanisms. Anesthesiology 2006; 104 (01) 158-169
6 Kalra P. Millerʼs Anesthesia, Volumes 1 and 2, 7th Edition. Anesthesiology 2010; 112 (01) 260-261
7 McManus MC. Neuromuscular blockers in surgery and intensive care, Part 1. Am J Health Syst Pharm 2001; 58 (23) 2287-2299
8 Frampton JE, McTavish D. Mivacurium. A review of its pharmacology and therapeutic potential in general anaesthesia. Drugs 1993; 45 (06) 1066-1089
9 D'Souza RS, Johnson RL. Nondepolarizing Paralytics. Treasure Island, FL: StatPearls Publishing; 2018
10 Butcher RG. Cases of traumatic tetanus, treated by different methods. Dublin Q J Med Sci 1855; 19 (02) 302-314
11 Bowman WC. Neuromuscular block. Br J Pharmacol 2006; 147 (Suppl 1): S277-S286
12 Griffith HR, Johnson GE. The use of curare in general anesthesia. Anesthesiology 1942; 3: 418-420
13 Sinclair RC, Luxton MC. Rapid sequence induction. Contin Educ Anaesth Crit Care Pain 2005; 5 (02) 45-48
14 Kirtania J, Ray S. Beware of lung complications when using guidewire-assisted nasogastric tube insertion---author's reply. Anesth Analg 2013; 116 (01) 263-264
15 Mehta S, Burry L, Fischer S. , et al; Canadian Critical Care Trials Group. Canadian survey of the use of sedatives, analgesics, and neuromuscular blocking agents in critically ill patients. Crit Care Med 2006; 34 (02) 374-380
16 Rhoney DH, Murry KR. National survey of the use of sedating drugs, neuromuscular blocking agents, and reversal agents in the intensive care unit. J Intensive Care Med 2003; 18 (03) 139-145
17 Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967; 2 (7511): 319-323
18 Light RW, Bengfort JL, George RB. The adult respiratory distress syndrome and pancuronium bromide. Anesth Analg 1975; 54 (02) 219-223
19 Bishop MJ. Hemodynamic and gas exchange effects of pancuronium bromide in sedated patients with respiratory failure. Anesthesiology 1984; 60 (04) 369-371
20 Hansen-Flaschen JH, Brazinsky S, Basile C, Lanken PN. Use of sedating drugs and neuromuscular blocking agents in patients requiring mechanical ventilation for respiratory failure. A national survey. JAMA 1991; 266 (20) 2870-2875
21 Merriman HM. The techniques used to sedate ventilated patients. A survey of methods used in 34 ICUs in Great Britain. Intensive Care Med 1981; 7 (05) 217-224
22 Segredo V, Caldwell JE, Matthay MA, Sharma ML, Gruenke LD, Miller RD. Persistent paralysis in critically ill patients after long-term administration of vecuronium. N Engl J Med 1992; 327 (08) 524-528
23 Ranieri VM, Rubenfeld GD, Thompson BT. , et al; ARDS Definition Task Force. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012; 307 (23) 2526-2533
24 Papazian L, Forel J-M, Gacouin A. , et al; ACURASYS Study Investigators. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 2010; 363 (12) 1107-1116
25 Huang DT, Angus DC, Moss M. , et al; Reevaluation of Systemic Early Neuromuscular Blockade Protocol Committee and the National Institutes of Health National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Network Investigators. Design and rationale of the Reevaluation of Systemic Early Neuromuscular Blockade Trial for acute respiratory distress syndrome. Ann Am Thorac Soc 2017; 14 (01) 124-133
26 Gainnier M, Roch A, Forel J-M. , et al. Effect of neuromuscular blocking agents on gas exchange in patients presenting with acute respiratory distress syndrome. Crit Care Med 2004; 32 (01) 113-119
27 Forel J-M, Roch A, Marin V. , et al. Neuromuscular blocking agents decrease inflammatory response in patients presenting with acute respiratory distress syndrome. Crit Care Med 2006; 34 (11) 2749-2757
28 Lyu G, Wang X, Jiang W, Cai T, Zhang Y. Clinical study of early use of neuromuscular blocking agents in patients with severe sepsis and acute respiratory distress syndrome [in Chinese]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2014; 26 (05) 325-329
29 Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. ; Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000; 342 (18) 1301-1308
30 Vender JS, Szokol JW, Murphy GS, Nitsun M. Sedation, analgesia, and neuromuscular blockade in sepsis: an evidence-based review. Crit Care Med 2004; 32 (11, Suppl): S554 –S561
31 Bellani G, Laffey JG, Pham T. , et al; LUNG SAFE Investigators; ESICM Trials Group. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016; 315 (08) 788-800
32 Alhurani RE, Oeckler RA, Franco PM, Jenkins SM, Gajic O, Pannu SR. ; National Survey of Adult Intensivists. Refractory hypoxemia and use of rescue strategies. A U.S. national survey of adult intensivists. Ann Am Thorac Soc 2016; 13 (07) 1105-1114
33 Duan EH, Adhikari NKJ, D'Aragon F. , et al; Canadian Critical Care Trials Group. Management of acute respiratory distress syndrome and refractory hypoxemia. A multicenter observational study. Ann Am Thorac Soc 2017; 14 (12) 1818-1826
34 Munshi L, Gershengorn HB, Fan E. , et al. Adjuvants to mechanical ventilation for acute respiratory failure. Adoption, de-adoption, and factors associated with selection. Ann Am Thorac Soc 2017; 14 (01) 94-102
35 Torbic H, Bauer SR, Personett HA. , et al. Perceived safety and efficacy of neuromuscular blockers for acute respiratory distress syndrome among medical intensive care unit practitioners: a multicenter survey. J Crit Care 2017; 38: 278-283
36 Hraiech S, Forel J-M, Papazian L. The role of neuromuscular blockers in ARDS: benefits and risks. Curr Opin Crit Care 2012; 18 (05) 495-502
37 Tremblay LN, Slutsky AS. Ventilator-induced lung injury: from the bench to the bedside. Intensive Care Med 2006; 32 (01) 24-33
38 Slutsky AS. Neuromuscular blocking agents in ARDS. N Engl J Med 2010; 363 (12) 1176-1180
39 Barnes T, Zochios V, Parhar K. Re-examining permissive hypercapnia in ARDS: a narrative review. Chest 2018; 154 (01) 185-195
40 Chanques G, Kress JP, Pohlman A. , et al. Impact of ventilator adjustment and sedation-analgesia practices on severe asynchrony in patients ventilated in assist-control mode. Crit Care Med 2013; 41 (09) 2177-2187
41 Marik PE, Kaufman D. The effects of neuromuscular paralysis on systemic and splanchnic oxygen utilization in mechanically ventilated patients. Chest 1996; 109 (04) 1038-1042
42 Chiumello D, Pristine G, Slutsky AS. Mechanical ventilation affects local and systemic cytokines in an animal model of acute respiratory distress syndrome. Am J Respir Crit Care Med 1999; 160 (01) 109-116
43 Fanelli V, Morita Y, Cappello P. , et al. Neuromuscular blocking agent cisatracurium attenuates lung injury by inhibition of nicotinic acetylcholine receptor-α1. Anesthesiology 2016; 124 (01) 132-140
44 Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med 2014; 370 (17) 1626-1635
45 De Jonghe B, Sharshar T, Lefaucheur J-P. , et al; Groupe de Réflexion et d'Etude des Neuromyopathies en Réanimation. Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA 2002; 288 (22) 2859-2867
46 Bolton CF, Gilbert JJ, Hahn AF, Sibbald WJ. Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry 1984; 47 (11) 1223-1231
47 Gutmann L, Gutmann L. Critical illness neuropathy and myopathy. Arch Neurol 1999; 56 (05) 527-528
48 De Jonghe B, Bastuji-Garin S, Durand M-C. , et al; Groupe de Réflexion et d'Etude des Neuromyopathies en Réanimation. Respiratory weakness is associated with limb weakness and delayed weaning in critical illness. Crit Care Med 2007; 35 (09) 2007-2015
49 Garnacho-Montero J, Madrazo-Osuna J, García-Garmendia JL. , et al. Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients. Intensive Care Med 2001; 27 (08) 1288-1296
50 Watling SM, Dasta JF. Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: a review of the literature. Crit Care Med 1994; 22 (05) 884-893
51 Griffiths RD, Hall JB. Intensive care unit-acquired weakness. Crit Care Med 2010; 38 (03) 779-787
52 Puthucheary Z, Rawal J, Ratnayake G, Harridge S, Montgomery H, Hart N. Neuromuscular blockade and skeletal muscle weakness in critically ill patients: time to rethink the evidence?. Am J Respir Crit Care Med 2012; 185 (09) 911-917
53 Price DR, Mikkelsen ME, Umscheid CA, Armstrong EJ. Neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness: a systematic review and meta-analysis. Crit Care Med 2016; 44 (11) 2070-2078
54 Rhodes A, Evans L, Alhazzani W. , et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 2017; 43 (03) 304-377
55 Hardin KA, Seyal M, Stewart T, Bonekat HW. Sleep in critically ill chemically paralyzed patients requiring mechanical ventilation. Chest 2006; 129 (06) 1468-1477
56 Steingrub JS, Lagu T, Rothberg MB, Nathanson BH, Raghunathan K, Lindenauer PK. Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically ventilated patients with severe sepsis. Crit Care Med 2014; 42 (01) 90-96
57 Barmparas G, Dhillon NK, Tatum JM. , et al. Extended neuromuscular blockade in acute respiratory distress syndrome does not increase mortality. J Surg Res 2018; 231: 434-440
58 Sottile PD, Kiser TH, Burnham EL. , et al; Colorado Pulmonary Outcomes Research Group (CPOR). An observational study of the efficacy of cisatracurium compared with vecuronium in patients with or at risk for acute respiratory distress syndrome. Am J Respir Crit Care Med 2018; 197 (07) 897-904
59 Huang DT, Papazian L. Is cisatracurium the neuromuscular blocking agent of choice in acute respiratory distress syndrome?. Am J Respir Crit Care Med 2018; 197 (07) 849-850
60 Murray MJ, DeBlock H, Erstad B. , et al. Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient. Crit Care Med 2016; 44 (11) 2079-2103
61 Rudis MI, Sikora CA, Angus E. , et al. A prospective, randomized, controlled evaluation of peripheral nerve stimulation versus standard clinical dosing of neuromuscular blocking agents in critically ill patients. Crit Care Med 1997; 25 (04) 575-583
62 Strange C, Vaughan L, Franklin C, Johnson J. Comparison of train-of-four and best clinical assessment during continuous paralysis. Am J Respir Crit Care Med 1997; 156 (05) 1556-1561
63 Baumann MH, McAlpin BW, Brown K. , et al. A prospective randomized comparison of train-of-four monitoring and clinical assessment during continuous ICU cisatracurium paralysis. Chest 2004; 126 (04) 1267-1273
64 Bouju P, Tadié J-M, Barbarot N. , et al. Clinical assessment and train-of-four measurements in critically ill patients treated with recommended doses of cisatracurium or atracurium for neuromuscular blockade: a prospective descriptive study. Ann Intensive Care 2017; 7 (01) 10
65 Groetzinger LM, Rivosecchi RM, Kane-Gill SL, Donahoe MP. Association Between Train-of-Four Values and Gas Exchange Indices in Moderate to Severe Acute Respiratory Distress Syndrome. Ann Pharmacother 2016; 50 (12) 1009-1015
66 Briel M, Meade M, Mercat A. , et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010; 303 (09) 865-873
67 Needham DM, Yang T, Dinglas VD. , et al. Timing of low tidal volume ventilation and intensive care unit mortality in acute respiratory distress syndrome. A prospective cohort study. Am J Respir Crit Care Med 2015; 191 (02) 177-185
68 Nota C, Santamaria JD, Reid D, Tobin AE. The impact of an education program and written guideline on adherence to low tidal volume ventilation. Crit Care Resusc 2016; 18 (03) 174-180
69 Salihoĝlu Z, Demiroluk S, Köse Y, Zengin K, Taskin M, Gökay BV. Neuromuscular effects of cisatracurium in morbidly obese patients. Middle East J Anaesthesiol 2008; 19 (04) 831-839
70 Pühringer FK, Keller C, Kleinsasser A, Giesinger S, Benzer A. Pharmacokinetics of rocuronium bromide in obese female patients. Eur J Anaesthesiol 1999; 16 (08) 507-510
71 Schwartz AE, Matteo RS, Ornstein E, Halevy JD, Diaz J. Pharmacokinetics and pharmacodynamics of vecuronium in the obese surgical patient. Anesth Analg 1992; 74 (04) 515-518
72 Varin F, Ducharme J, Théorêt Y, Besner JG, Bevan DR, Donati F. Influence of extreme obesity on the body disposition and neuromuscular blocking effect of atracurium. Clin Pharmacol Ther 1990; 48 (01) 18-25
73 Weinstein JA, Matteo RS, Ornstein E, Schwartz AE, Goldstoff M, Thal G. Pharmacodynamics of vecuronium and atracurium in the obese surgical patient. Anesth Analg 1988; 67 (12) 1149-1153
74 Tsueda K, Warren JE, McCafferty LA, Nagle JP. Pancuronium bromide requirement during anesthesia for the morbidly obese. Anesthesiology 1978; 48 (06) 438-439
75 van Kralingen S, van de Garde EM, Knibbe CA. , et al. Comparative evaluation of atracurium dosed on ideal body weight vs. total body weight in morbidly obese patients. Br J Clin Pharmacol 2011; 71 (01) 34-40
76 Tsai-Nguyen G, Modrykamien AM. Use of neuromuscular blocking agents in acute respiratory distress syndrome. Proc Bayl Univ Med Cent 2018; 31 (02) 177-179
77 Paterson IG, Hood JR, Russell SH, Weston MD, Hirsch NP. Mivacurium in the myasthenic patient. Br J Anaesth 1994; 73 (04) 494-498
78 Cammu G, Boussemaere V, Foubert L, Hendrickx J, Coddens J, Deloof T. Large bolus dose vs. continuous infusion of cisatracurium during hypothermic cardiopulmonary bypass surgery. Eur J Anaesthesiol 2005; 22 (01) 25-29
79 Rosenberg JB, Eisen LA. Eye care in the intensive care unit: narrative review and meta-analysis. Crit Care Med 2008; 36 (12) 3151-3155
80 Tamion F, Hamelin K, Duflo A, Girault C, Richard J-C, Bonmarchand G. Gastric emptying in mechanically ventilated critically ill patients: effect of neuromuscular blocking agent. Intensive Care Med 2003; 29 (10) 1717-1722