6/28/23, 12:02 AM ACURASYS Pathway Feedback Search Clinical Topics Home Studies ACURASYS ACURASYS Disease Acute respiratory distress syndr Trial question What is the role of cisatracurium in patients with severe ARDS? Study design Multi-center Double blinded RCT Population 340 patients Inclusion criteria: patients presenting to the ICU with severe ARDS beginning within the previous 48 hours Key exclusion criteria: age < 18 years, lack of consent, continuous infusion of a neuromuscular blocking agent at enrollment, known pregnancy, increased ICP, severe chronic liver disease, or BMT or chemotherapy-induced neutropenia Interventions N=178 early neuromuscular blockade (using cisatracurium besylate for 48 hours) N=162 placebo (matching placebo for 48 hours) Primary outcome Death at 90 days 40.7 % 40.7 31.6 30.5 % 20.4 % 10.2 % Borderline significant decrease https://web.pathway.md/studies/rec0qvbQIcYJKMgis 1/2 6/28/23, 12:02 AM ACURASYS Pathway 0.0 % Early neuromuscular blockade Placebo Borderline significant decrease in death at 90 days (31.6% vs. 40.7%; HR 0.68, 95% CI 0.48 to 0.98) Secondary outcomes Borderline significant decrease in death at 28 days (23.7% vs. 33.3%; RR 0.71, 95% CI 0.51 to 1) Significant decrease in pneumothorax (4% vs. 11.7%; RR 0.34, 95% CI 0.15 to 0.78) Safety outcomes No significant difference in ICU-acquired paresis. Conclusion In patients presenting to the ICU with severe ARDS beginning within the previous 48 hours, early neuromuscular blockade was superior to placebo with respect to death at 90 days. Reference Papazian L, Forel JM, Gacouin A et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med. 2010 Sep 16;363(12):1107-16. Open reference URL https://web.pathway.md/studies/rec0qvbQIcYJKMgis 2/2