Cisatracurium ups some ARDS outcomes versus vecuronium

(HealthDay)—Among patients with acute respiratory distress syndrome (ARDS), cisatracurium does not improve mortality versus 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, M.D., 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 authors used propensity matching to balance patient- and hospital-specific factors in a cohort of 3,082 patients (1,901 per group).

The researchers found that there was no significant between-group difference in mortality (odds ratio, 0.932; P = 0.4) or hospital days (−0.66; P = 0.411). Fewer ventilator days (−1.01; P = 0.005) and intensive care unit days (−0.98; P = 0.28) were seen for patients treated with cisatracurium; however, they were equally likely to be discharged home (odds ratio, 1.19; P = 0.056).

"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 write. "These data suggest that cisatracurium may be the preferred neuromuscular blocking agent for patients at risk for and with ARDS."