Dosing Strategies for Paralytics in ARDS: Keep It Steady or Time for a Change? Continuous/Flat-Dose Strategies
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Pharmacology, Pulmonary, 2022
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The use of neuromuscular blocking agents (NMBAs) has been established as part of the treatment strategy for patients with acute respiratory distress syndrome (ARDS). However, the optimal approach to dosing NMBAs for patients is still controversial. The 2016 Society of Critical Care Medicine guidelines on the use of NMBAs did not discuss whether to utilize a continuous infusion (titrated or flat dose) or intermittent doses. The two major trials to date, ACURASYS and ROSE-PETAL, both used a continuous infusion (flat dose) approach. However, with the numerous adverse effects associated with NMBAs, an intermittent strategy could be considered to reduce the total dose and lessen these adverse effects. Furthermore, the ROSE trial did not show benefit with a continuous infusion (flat dose) approach. This session will comprise two pro/con sessions that will discuss the therapeutic yield of neuromuscular blockade, dosing approaches to NMBAs in ARDS, and the monitoring and potential long-term sequelae of NMBAs.
Meta Tag
Content Type Presentation
Knowledge Area Pharmacology
Knowledge Area Pulmonary
Knowledge Level Advanced
Membership Level Select
Tag Pharmacology
Tag Acute Respiratory Distress Syndrome ARDS
Year 2022
dosing strategies
acute respiratory distress syndrome
continuous flat dose strategy
mortality reduction
improving outcomes


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