Comparing Treatments for Acute Respiratory Distress Syndrome

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Patients with ARDS who were treated with cisatracurium had fewer days on ventilation.
Patients with ARDS who were treated with cisatracurium had fewer days on ventilation.

HealthDay News — In patients with acute respiratory distress syndrome (ARDS), cisatracurium does not improve mortality vs vecuronium but is associated with improvements in other outcomes, according to a study published online in the American Journal of Respiratory and Critical Care Medicine.

Peter D. Sottile, MD, from the University of Colorado School of Medicine in Aurora, and colleagues compared outcomes with cisatracurium and vecuronium in patients at risk for and with ARDS. The researchers used propensity matching to balance patient- and hospital-specific factors in a cohort of 3082 patients (1901 per group).

The researchers found that there was no significant between-group difference in mortality (odds ratio, 0.932; P =.4) or hospital days (−0.66; P =.411). Fewer ventilator days (−1.01; P =.005) and intensive care unit days (−0.98; P =.28) were seen for patients treated with cisatracurium; however, they were equally likely to be discharged home (odds ratio, 1.19; P =.056).

"When compared to vecuronium, cisatracurium was not associated with a difference in mortality, but was associated with improvements in other clinically important outcomes," the authors woite. "These data suggest that cisatracurium may be the preferred neuromuscular blocking agent for patients at risk for and with ARDS."

Reference

Sottile PD, Kiser TH, Burnham EL, et al. An observational study of the efficacy of cisatracurium compared to vecuronium in patients with or at risk for ARDS [published online December 14, 2017]. Am J Respir Crit Care Med. doi:10.1164/rccm.201706-11320C

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