RT Journal Article
SR Electronic
T1 A Survey of Academic Intensivists' Use of Neuromuscular Blockade in Subjects With ARDS
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.07026
DO 10.4187/respcare.07026
A1 Neal N Dodia
A1 Mary E Richert
A1 Andrew R Deitchman
A1 Charlene C Quinn
A1 Ellen T Marciniak
A1 Clayton H Brown
A1 Michael L Terrin
A1 Diana E Amariei
A1 Carl B Shanholtz
A1 Jeffrey D Hasday
YR 2019
UL http://rc.rcjournal.com/content/early/2019/09/10/respcare.07026.abstract
AB BACKGROUND: Our Cooling to Help Injured Lungs (CHILL) trial of therapeutic hypothermia in ARDS includes neuromuscular blockade (NMB) as an inclusion criterion to avoid shivering. NMB has been used to facilitate mechanical ventilation in ARDS and was shown to reduce mortality in the ACURASYS trial. To assess the feasibility of a multi-center CHILL trial, we conducted a survey of academic intensivists about their NMB use in patients with ARDS.METHODS: We distributed via email a 16-question survey about NMB use in patients with ARDS including frequency, indications, and dosing strategy.RESULTS: 212 (24.3%) of 871 respondents completed the survey: 94.7% were board-certified in internal medicine, 88% in pulmonary and critical care; 90.3% practiced in academic medical centers, with 87% working in medical ICUs; 96.6% of respondents who treat ARDS use NMB, and 39.7% use NMB in ≥ 50% of these patients. Of 4 listed indications for initiating NMB in ARDS, allowing adherence with lung-protective ventilator strategies and patient–ventilator synchrony were cited as the most important reasons, followed by the results of the ACURASYS trial and facilitating prone positioning.CONCLUSIONS: We conclude that NMB is frequently used by academic intensivists to facilitate mechanical ventilation in patients with moderate to severe ARDS.