{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:32:57Z","timestamp":1785371577825,"version":"3.55.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Studies evaluating neuromuscular blocking agents (NMBAs) in the management of ARDS have produced inconsistent results in terms of their effect on mortality. The purpose of this systematic review and meta-analysis was to evaluate differences in mortality comparing subjects with ARDS who received NMBA to those who received placebo or usual care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We searched Ovid, MEDLINE, Embase, CINAHL, Cochrane, Scopus, and Web of Science for randomized controlled trials evaluating administration of NMBAs in subjects with ARDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We included 6 studies (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 1,558 subjects) from 1,814 abstracts identified by our search strategy. The use of early, continuous-infusion NMBAs reduces the risk of short-term (ie, 21\u201328-d) mortality (relative risk 0.71 [95% CI 0.52\u20130.98],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .030,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 60%) in subjects with ARDS but does not reduce the risk of long-term (ie, 90-d) mortality (relative risk 0.81 [95% CI 0.64\u20131.04],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .10,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 54%). NMBAs decreased the risk of barotrauma (relative risk 0.55 [95% CI 0.35\u20130.85],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%) and pneumothorax (relative risk 0.46 [95% CI 0.28\u20130.77],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%) compared to control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In subjects with ARDS, early use of NMBAs improves oxygenation, reduces the incidence of ventilator-induced lung injury, and decreases 21\u201328-d mortality, but it does not improve 90-d mortality. NMBAs should be considered for select patients with moderate-to-severe ARDS for short durations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.07849","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T17:15:18Z","timestamp":1598375718000},"page":"120-128","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Neuromuscular Blocking Agents for ARDS: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"66","author":[{"given":"Heather","family":"Torbic","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Pat","family":"Harnegie","sequence":"additional","affiliation":[{"name":"Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijit","family":"Duggal","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1608077"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201703-0548ST"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005043421801"},{"issue":"5","key":"e_1_3_2_5_2","first-page":"567","article-title":"Pharmacological treatments for acute respiratory distress syndrome: systematic review","volume":"81","author":"Duggal A","year":"2015","unstructured":"Duggal A, , Ganapathy A, , Ratnapalan M, , Adhikari NK. Pharmacological treatments for acute respiratory distress syndrome: systematic review. Minerva Anestesiol, 2015; 81(5):567\u2013588.","journal-title":"Minerva Anestesiol"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1007136"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-4040-6"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e328357efe1"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000104114.72614.BC"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000239435.87433.0D"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005372"},{"issue":"5","key":"e_1_3_2_12_2","first-page":"325","article-title":"[Clinical study of early use of neuromuscular blocking agents in patients with severe sepsis and acute respiratory distress syndrome]","volume":"26","author":"Lyu G","year":"2014","unstructured":"Lyu G, , Wang X, , Jiang W, , Cai T, , Zhang Y. [Clinical study of early use of neuromuscular blocking agents in patients with severe sepsis and acute respiratory distress syndrome]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2014; 26(5):325\u2013329.","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4653-4"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901686"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0291"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.01.041"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0259-8"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.22.2859"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc12557"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002057"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3692-6"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1817"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1905627"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.09.031"},{"issue":"10","key":"e_1_3_2_28_2","first-page":"980","article-title":"Ventilator-induced lung injury","volume":"370","author":"Slutsky AS","year":"2014","unstructured":"Slutsky AS, , Ranieri VM. Ventilator-induced lung injury. 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