ACURASYS Trial Summary: NM blockers in ARDS
2010 ACURASYS TRIAL Neuromuscular Blockers in Early Acute Respiratory Distress Syndrome Multicenter, double-blinded, placebo-controlled trial Objective: To assess if administration of cisatracurium improve survival when compared to placebo in ICU patients undergoing mechanical ventilation for early severe ARDS 340 patients on mechanical ventilation for < 48 hours with ARDS (PaO2: FiO2 <150, PEEP ≥ 5cmH20 and TV of 6-8mL/kg) were randomized to: 8 31.6 Cisatracurium (n=178) VS Placebo (n=162) 8- PRIMARY OUTCOME Mortality before discharge or 90 days % RR 0.68; 95% CI 0.48-0.98; P=0.04; NNT=11 SECONDARY OUTCOME 40.7 23.7 28-day mortality % 33.3 RR 0.71; 95% CI 0.51-1.00; P=0.05 53.1 Number of ventilator-free days Day 1-90% P=0.03 44.6 Conclusion: Paralysis with cisatracurium for 48 hours in patients with early severe ARDS improves 90 day survival and increases ventilator-free days. Papazian L, et al. NEJM 2010. 363(12):1107-1116.