{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:43:33Z","timestamp":1791855813663,"version":"4.3.4"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between neuromuscular blockade agent (NMBA) use and outcome in dogs undergoing mechanical ventilation (MV), including survival to discharge, and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records for 227 mechanically ventilated dogs were reviewed for NMBA use, parameters of respiratory status (PaO<jats:sub>2<\/jats:sub>, PCO<jats:sub>2<\/jats:sub>, PF ratio, SpO<jats:sub>2<\/jats:sub>), MV settings, MV complications, and survival outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The NMBA and non-NMBA groups included 28 and 199 dogs, respectively. The median partial pressures of oxygen in arterial blood (PaO<jats:sub>2<\/jats:sub>) in the NMBA and non-NMBA groups were 63 and 57 mmHg, respectively (<jats:italic>P<\/jats:italic> = 0.24). The median partial pressures of blood carbon dioxide levels were 58 and 51 mmHg, respectively (<jats:italic>P<\/jats:italic> = 0.07). The pulse oximetry percentage (SpO<jats:sub>2<\/jats:sub>) prior to initiation of MV were 88 and 94%, respectively (<jats:italic>P<\/jats:italic> = 0.02). The median PF ratios prior to MV were 90 and 215, respectively (<jats:italic>P<\/jats:italic> = 0.02). The median durations of MV were 18 and 24 h, respectively (<jats:italic>P<\/jats:italic> = 0.32). Eight (28.6%) dogs that received NMBAs survived to discharge, while 51 dogs (32.3%) that did not receive NMBAs survived to discharge (<jats:italic>P<\/jats:italic> = 0.87). Both PF ratio and SpO<jats:sub>2<\/jats:sub> values were significantly lower in dogs that received NMBAs compared to dogs that did not (<jats:italic>P<\/jats:italic> = 0.02 and <jats:italic>P<\/jats:italic> = 0.02, respectively). There was no significant difference in tidal volume or peak inspiratory pressure at the time of MV initiation (<jats:italic>P<\/jats:italic> = 0.17 and <jats:italic>P<\/jats:italic> = 0.09, respectively). There was no significant difference between the incidence of complications in dogs that received NMBAs and those that did not (<jats:italic>P<\/jats:italic> = 0.08).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed no statistical significance between NMBA use and survival or complications. However, dogs in the NMBA group likely had more severe hypoxemia than the non-NMBA group, as indicated by their lower PF ratios and SPO<jats:sub>2<\/jats:sub> values prior to initiation of mechanical ventilation. The similarities in survival rate between the NMBA and non-NMBA patient populations, despite higher severity of respiratory pathology in the NMBA group, may suggest a potential therapeutic benefit to NMBA use for MV patients. Further investigation into the use of NMBAs in patients undergoing MV are warranted.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fvets.2025.1539138","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T13:08:26Z","timestamp":1741180106000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The association between non-depolarizing neuromuscular blockade agents and survival to discharge in dogs undergoing mechanical ventilation: a multi-center retrospective study of 227 dogs (2010\u20132020)"],"prefix":"10.3389","volume":"12","author":[{"given":"Lena","family":"Ngo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Walton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyssa","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasia","family":"Ludwik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt","family":"Thevelein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Blong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiazhang","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Mochel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"572","DOI":"10.2215\/CJN.13091021","article-title":"Management of respiratory failure: ventilator management 101 and noninvasive ventilation","volume":"17","author":"Pearson","year":"2022","journal-title":"CJASN."},{"key":"B2","doi-asserted-by":"publisher","first-page":"3000605221128148","DOI":"10.1177\/03000605221128148","article-title":"Neuromuscular blocking agents in the intensive care unit","volume":"50","author":"Rodr\u00edguez-Blanco","year":"2022","journal-title":"J Int Med Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.1097\/CCM.0000000000002027","article-title":"Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient","volume":"44","author":"Murray","year":"2016","journal-title":"Crit Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"273","DOI":"10.5152\/TJAR.2019.33269","article-title":"Current use of neuromuscular blocking agents in intensive care units","volume":"47","author":"Tezcan","year":"2019","journal-title":"Turk J Anaesthesiol Reanim."},{"key":"B5","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.jcrc.2018.10.019","article-title":"Neuromuscular blocking agents for acute respiratory distress syndrome","volume":"49","author":"Torbic","year":"2019","journal-title":"J Crit Care."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2749","DOI":"10.1097\/01.CCM.0000239435.87433.0D","article-title":"Neuromuscular blocking agents decrease inflammatory response in patients presenting with acute respiratory distress syndrome","volume":"34","author":"Forel","year":"2006","journal-title":"Crit Care Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1056\/NEJMoa1005372","article-title":"Neuromuscular blockers in early acute respiratory distress syndrome","volume":"363","author":"Papazian","year":"2010","journal-title":"N Engl J Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1007\/s00134-020-06297-8","article-title":"Myorelaxants in ARDS patients","volume":"46","author":"Hraiech","year":"2020","journal-title":"Intensive Care Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1111\/j.1399-6576.2007.01292.x","article-title":"Stressful memories and psychological distress in adult mechanically ventilated intensive care patients\u2013a 2-month follow-up study","volume":"51","author":"Samuelson","year":"2007","journal-title":"Acta Anaesthesiol Scand."},{"key":"B10","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1677\/joe.0.1800439","article-title":"Physiological reactions to fear provocation in dogs","volume":"180","author":"Hydbring-Sandberg","year":"2004","journal-title":"Journal of Endocrinology."},{"key":"B11","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1056\/NEJM199208203270804","article-title":"Persistent paralysis in critically ill patients after long-term administration of vecuronium","volume":"327","author":"Segredo","year":"1992","journal-title":"N Engl J Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1111\/vec.12989","article-title":"Seizure activity following atracurium continuous rate infusion in three mechanically ventilated juvenile dogs","volume":"30","author":"Donaldson","year":"2020","journal-title":"J Vet Emerg Crit Care."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/vrc2.59","article-title":"Persistent hypotension resolved by neostigmine administration in a dog in which atracurium was used","author":"Vettorato","year":"2021","journal-title":"Vet Record"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/vrc2.101","article-title":"A suspected non-allergic anaphylactic reaction to intravenous administration of atracurium in a dog","author":"Testa","year":"2021","journal-title":"Vet Record"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.1056\/NEJMoa1901686","article-title":"Early neuromuscular blockade in the acute respiratory distress syndrome","volume":"380","year":"2019","journal-title":"N Engl J Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1055\/s-0040-1708557","article-title":"Early Neuromuscular blockade in children with pediatric acute respiratory distress syndrome","volume":"9","author":"Chandra","year":"2020","journal-title":"J Pediatr Intensive Care."},{"key":"B17","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S0195-5616(92)50630-1","article-title":"Advantages of and guidelines for using neuromuscular blocking agents","volume":"22","author":"Ilkiw","year":"1992","journal-title":"Vet Clin North Am Small Anim Pract."},{"key":"B18","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1111\/vec.13176","article-title":"Indications and outcome associated with positive-pressure ventilation in dogs and cats: 127 cases","volume":"32","author":"Cagle","year":"2022","journal-title":"J Vet Emerg Crit Care."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1007\/s00134-016-4423-3","article-title":"Quantifying unintended exposure to high tidal volumes from breath stacking dyssynchrony in ARDS: the BREATHE criteria","volume":"42","author":"Beitler","year":"2016","journal-title":"Intensive Care Med."},{"key":"B20","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: Elegant Graphics for Data Analysis.","author":"Wickham","year":"2016"}],"container-title":["Frontiers in Veterinary Science"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fvets.2025.1539138\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T13:08:28Z","timestamp":1741180108000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fvets.2025.1539138\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":20,"alternative-id":["10.3389\/fvets.2025.1539138"],"URL":"https:\/\/doi.org\/10.3389\/fvets.2025.1539138","relation":{},"ISSN":["2297-1769"],"issn-type":[{"value":"2297-1769","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"article-number":"1539138"}}