2019/09/10 by Neal N Dodia, N. Dodia, Mary Richert +17
Medicine · #Cardiac Arrest and Resuscitation #Respiratory Support and Mechanisms #Thermal Regulation in Medicine
paper · pdf · doi:10.4187/respcare.07026
crossref issued 2019/09/10 · crossref published 2019/09/10 · crossref published-online 2019/09/10 · openalex publication_date 2019/09/10 · crossref created 2019/09/10 · crossref published-print 2020/03/01 · openalex created_date 2025/10/10 · crossref deposited 2026/04/06 · crossref indexed 2026/07/30 · openalex updated_date 2026/07/30
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.