Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 6 3 2021 09 01 Neuromuscular Blocking Agent Use in Acute Respiratory Distress Syndrome: Which Variable is Important? 116 122 126231 10.34172/hpr.2021.22 EN Farshid Rahimibashar Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran 0000-0001-8818-7209 Mahmood Salesi Chemical Injuries Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran 0000-0003-3042-2143 Amir Vahedian-Azimi Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran 0000-0002-1678-7608 Masoum Khosh Fetrat Department of Anesthesiology and Critical Care, Khatamolanbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran 0000-0003-0346-9114 Journal Article 2021 01 15 <strong>Background</strong><strong>: </strong>The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality.<br /><strong>Objectives: </strong>The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA.<br /><strong>Methods: </strong>A retrospective secondary analysis of 4200 patients with ARDS was collected from two academic medical centers, Tehran, Iran. This study was performed to assess the impact of NMBAs use in ARDS patients with different subgroups including mild and moderate-to-severe ARDS, age more and less than 65 years, having medical turnover vs. not-having, and high acute nursing care vs. moderate to low nursing care.<br /><strong>Results: </strong>Intensive care unit (ICU) mortality has occurred in 1169 (27.8%) participants. The mortality rate was 28.6% and 27.5% in patients with mild and moderate-to-severe ARDS, respectively. In the subjects without medical turnover, the moderate dose of NMBAs significantly reduces the mortality of patients (<em>P </em>= 0.044). In patients who need high acute nursing care, increasing the NMBAs dose significantly reduces patients’ mortality (<em>P </em>= 0.010). In addition, increasing the NMBAs doses significantly reduces ICU length of stay (LOS).<br /><strong>Conclusion: </strong>This study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS. However, higher doses of NMBAs than low doses increased the risk of mortality in patients over 80 years and can reduce the risk of death in patients less than 55 years. https://www.jhpr.ir/article_126231_97d325c325b1600e99c2289cee503719.pdf