Respiratory failure & ventilation
Heterogenous treatment effect of neuromuscular blocking agents for moderate-to-severe ARDS: a post hoc Markov model re-analysis of the ACURASYS trial
An erratum to this article was published (Intensive Care Med, Nov 2025 ↗)
Authors' conclusion
The systematic and short-term administration of cisatracurium in patients with moderate-to-severe ARDS appears to confer greater survival benefit in those with a higher baseline life expectancy.
Study context
- Population
- Patients with moderate-to-severe ARDS in the ACURASYS trial
- Participants
- 321 patients
- Comparison
- Cisatracurium vs placebo
- Primary endpoint
- Mortality (daily clinical states: death, under mechanical ventilation, weaned and alive), by baseline characteristics
- Follow-up
- Day 90
Methodological detailsMarkov chain analysis, subgroup analysis, multicentre, double-blinded
- Markov chain analysis
- Subgroup analysis
- Multicentre
- Double-blinded
Primary result
As reported in the abstract
Estimated survival, age <60 years with non-fatal McCabe score (subgroup, N = 130)
Placebo
0.63
n = 62
Cisatracurium
0.93
n = 68
Further findings
- Estimated survival, PaO2:FiO2 > 100 mmHg at inclusion (subgroup, N = 98) · day 90 — Cisatracurium
- 0.92
Survival, rapidly or ultimately fatal McCabe prognosis (subgroup)
- Probability of survival did not differ substantially between placebo and cisatracurium
Daily probability of remaining mechanically ventilated, age ≥ 60 years (subgroup, N = 158)
- Not influenced by any covariate, including cisatracurium
- Confirmed by simulations
Original publication
Heterogenous treatment effect of neuromuscular blocking agents for moderate-to-severe ARDS: a post hoc Markov model re-analysis of the ACURASYS trial. Intensive Care Med. Published 6 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →