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
1   Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Alexander Kobzik
1   Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
David T. Huang
1   Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
2   Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
3   The MACRO Center (Multidisciplinary Acute Care Research Organization), University of Pittsburgh, Pittsburgh, Pennsylvania
4   The CRISMA Center (Clinical Research, Investigation, and Systems Modeling of Acute Illness), University of Pittsburgh, Pittsburgh, Pennsylvania
› Author Affiliations
Funding Dr. Huang is supported by 1U01HL123009–01, PETAL01ROSE, for the Reevaluation Of Systemic Early Neuromuscular Blockade (ROSE) trial.
Further Information

Publication History

Publication Date:
06 May 2019 (online)

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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.

Note

The work was performed at the University of Pittsburgh, and is dedicated to Katherine S. Huang.