Informations générales (source: ClinicalTrials.gov)
Effects of NMBA on the Alteration of Transpulmonary Pressures at the Early Phase of ARDS
Interventional
Phase 4
Assistance Publique Hopitaux De Marseille (Voir sur ClinicalTrials)
avril 2012
décembre 2014
29 juin 2024
Mortality in Acute Respiratory Distress Syndrome is high (40 to 60 %). Protective
mechanical ventilation, until 2010, was the cornerstone of the ARDS therapeutic
strategies. Recently, a prospective multicenter study demonstrates that a 48h continuous
infusion of neuromuscular blocking agents (NMBA) have a positive impact on mortality of
ARDS patients. (Papazian et al. ACURASYS Study. NEJM 2010; 363:1107-16). The mechanisms
through which NMBAs could improve survival remain speculative. They are as follows:
- reduction of the consumption of oxygen linked to ventilatory workload;
- increase of chest wall compliance improving mechanical ventilation during ARDS and
better adaptation to the protective ventilation strategy;
- anti-inflammatory effect contributing to a reduction in pulmonary inflammation and
improvement in oxygenation,
- reduction of the variations of transpulmonary pressure (TPP) by the way of better
synchronisation between patient and the ventilator.
The use of NMBA could also reduce the ventilator induced lung injury by a better control
of TPP.
Etablissements
| Les établissements hors Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| Assistance Publique Hopitaux de Marseille - 13354 - Marseille - France | magali BISBAL | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- Early (< 48H) Severe ARDS: PaO2 / FiO2 ratio < 150 with PEEP >= 5 cmH20
- Early (< 48H) Severe ARDS: PaO2 / FiO2 ratio < 150 with PEEP >= 5 cmH20
Age < 18 ans Patient already under continuous infusion NMBA. Known NMBA Allergy or
intolerance Contra-indication to introduction of nasogastric tube