{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:32:42Z","timestamp":1787934762290,"version":"build-2784847793"},"reference-count":90,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T00:00:00Z","timestamp":1708300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brazilian Council for Scientific and Technological Development","award":["408124\/2021-0"],"award-info":[{"award-number":["408124\/2021-0"]}]},{"name":"Brazilian Council for Scientific and Technological Development","award":["E-26\/010.001488\/2019"],"award-info":[{"award-number":["E-26\/010.001488\/2019"]}]},{"name":"Rio de Janeiro State Research Foundation","award":["408124\/2021-0"],"award-info":[{"award-number":["408124\/2021-0"]}]},{"name":"Rio de Janeiro State Research Foundation","award":["E-26\/010.001488\/2019"],"award-info":[{"award-number":["E-26\/010.001488\/2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The use of neuromuscular blocking agents (NMBAs) is common in the intensive care unit (ICU). NMBAs have been used in critically ill patients with lung diseases to optimize mechanical ventilation, prevent spontaneous respiratory efforts, reduce the work of breathing and oxygen consumption, and avoid patient\u2013ventilator asynchrony. In patients with acute respiratory distress syndrome (ARDS), NMBAs reduce the risk of barotrauma and improve oxygenation. Nevertheless, current guidelines and evidence are contrasting regarding the routine use of NMBAs. In status asthmaticus and acute exacerbation of chronic obstructive pulmonary disease, NMBAs are used in specific conditions to ameliorate patient\u2013ventilator synchronism and oxygenation, although their routine use is controversial. Indeed, the use of NMBAs has decreased over the last decade due to potential adverse effects, such as immobilization, venous thrombosis, patient awareness during paralysis, development of critical illness myopathy, autonomic interactions, ICU-acquired weakness, and residual paralysis after cessation of NMBAs use. The aim of this review is to highlight current knowledge and synthesize the evidence for the effects of NMBAs for critically ill patients with lung diseases, focusing on patient\u2013ventilator asynchrony, ARDS, status asthmaticus, and chronic obstructive pulmonary disease.<\/jats:p>","DOI":"10.3390\/jcm13041182","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T10:40:15Z","timestamp":1708339215000},"page":"1182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Management of Neuromuscular Blocking Agents in Critically Ill Patients with Lung Diseases"],"prefix":"10.3390","volume":"13","author":[{"given":"Ida Giorgia","family":"Iavarone","sequence":"first","affiliation":[{"name":"Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"},{"name":"Department of Surgical Sciences and Integrated Diagnostics, University of Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8945-8330","authenticated-orcid":false,"given":"Lou\u2019i","family":"Al-Husinat","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-4475","authenticated-orcid":false,"given":"Jorge Luis","family":"V\u00e9lez-P\u00e1ez","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias M\u00e9dicas, Universidad Central de Ecuador, Quito 170129, Ecuador"},{"name":"Unidad de Terapia Intensiva, Hospital Pablo Arturo Su\u00e1rez, Centro de Investigaci\u00f3n Cl\u00ednica, Quito 170129, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Robba","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"},{"name":"Department of Surgical Sciences and Integrated Diagnostics, University of Genova, 16132 Genova, Italy"},{"name":"Facultad de Ciencias M\u00e9dicas, Universidad Central de Ecuador, Quito 170129, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Leme","family":"Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1412-7136","authenticated-orcid":false,"given":"Patricia R. 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