{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:38:10Z","timestamp":1790617090681,"version":"4.1.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high Vt and high transpulmonary pressure. As an alternative to high-dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate whether partial neuromuscular blockade can facilitate lung-protective ventilation while maintaining diaphragm activity under partial ventilatory support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a proof-of-concept study, we enrolled 10 patients with lung injury and a Vt greater than 8 ml\/kg under pressure support ventilation (PSV) and under sedation. After baseline measurements, rocuronium administration was titrated to a target Vt of 6 ml\/kg during neurally adjusted ventilatory assist (NAVA). Thereafter, patients were ventilated in PSV and NAVA under continuous rocuronium infusion for 2 hours. Respiratory parameters, hemodynamic parameters, and blood gas values were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Rocuronium titration resulted in significant declines of Vt (mean\u2009\u00b1\u2009SEM, 9.3\u2009\u00b1\u20090.6 to 5.6\u2009\u00b1\u20090.2 ml\/kg; P\u2009&amp;lt;\u20090.0001), transpulmonary pressure (26.7\u2009\u00b1\u20092.5 to 10.7\u2009\u00b1\u20091.2 cm H2O; P\u2009&amp;lt;\u20090.0001), and diaphragm electrical activity (17.4\u2009\u00b1\u20092.3 to 4.5\u2009\u00b1\u20090.7 \u03bcV; P\u2009&amp;lt;\u20090.0001), and could be maintained under continuous rocuronium infusion. During titration, pH decreased (7.42\u2009\u00b1\u20090.02 to 7.35\u2009\u00b1\u20090.02; P\u2009&amp;lt;\u20090.0001), and mean arterial blood pressure increased (84\u2009\u00b1\u20096 to 99\u2009\u00b1\u20096 mm Hg; P\u2009=\u20090.0004), as did heart rate (83\u2009\u00b1\u20097 to 93\u2009\u00b1\u20098 beats\/min; P\u2009=\u20090.0004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Partial neuromuscular blockade facilitates lung-protective ventilation during partial ventilatory support, while maintaining diaphragm activity, in sedated patients with lung injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201605-1016oc","type":"journal-article","created":{"date-parts":[[2016,10,17]],"date-time":"2016-10-17T11:04:58Z","timestamp":1476702298000},"page":"1033-1042","source":"Crossref","is-referenced-by-count":90,"title":["Partial Neuromuscular Blockade during Partial Ventilatory Support in Sedated Patients with High Tidal Volumes"],"prefix":"10.1093","volume":"195","author":[{"given":"Jonne","family":"Doorduin","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joeke L.","family":"Nollet","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisanne H.","family":"Roesthuis","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hieronymus W. H.","family":"van Hees","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent J.","family":"Brochard","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, St. Michael\u2019s Hospital, Toronto, Ontario, Canada; and"},{"name":"Keenan Research Centre for Biomedical Science, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christer A.","family":"Sinderby","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, St. Michael\u2019s Hospital, Toronto, Ontario, Canada; and"},{"name":"Keenan Research Centre for Biomedical Science, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes G.","family":"van der Hoeven","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo M. 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