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Table 1 Characteristics of included trials

From: Neuromuscular blockade in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials

Trial author or trial nameGainnier et al. [10]Forel et al. [9]ACURASYS trial [11]Guervilly et al. [27]ROSE trial [19]
Year20042006201020172019
CountryFranceFranceFranceFranceUSA
NBMA vs control (patients)28 vs 2818 vs 18177 vs 16213 vs 11501 vs 505
PaO2/FIO2 ratio and PEEP for inclusion (cm H2O)< 150
> 5
< 200< 150
> 5
100–150
> 5
< 150
> 8
Important exclusion criteriaNMBA use within 2 weeksNMBA and steroids use within 2 weeksCurrent continuous infusion of NMBACurrent continuous infusion of NMBACurrent continuous infusion of NMBA
Ventilator management strategyLung protective ARDS net protocolLung protective ARDS net protocolLung protective ARDS net protocolLung protective ARDS net protocolLung protective high PEEP strategy
Cisatracurium doseBolus of 50 mg, 5 μg/kg/minBolus 0.2 mg/kg, 5 μg/kg/minBolus of 15 mg, 37.5 mg/hourBolus of 15 mg, 37.5 mg/hourBolus 15 mg, 37.5 mg/hour
Assessment for an extra doseTrain-of-fourTrain-of-fourPlateau pressure > 32Train-of-fourNo adjustment
Sedation goalRamsay 6Ramsay 6bRamsay 6Ramsay 6RASS − 4, − 5 in the intervention group
RASS 0 to − 1 in the control group)c
Risk of bias
 Sequence generationLowlowLowLowLow
 Allocation concealmentLowLowLowLowLow
 BlindingHighaHighaLowHighaHigha
 WithdrawalLowLowLowLowLow
 Selective outcomeLowLowLowLowLow
 Free of other biasLowLowLowLowLow
 OverallHighHighLowHighHigh
  1. aRisk was high because nurses are not blinded to the intervention group
  2. bRamsay scale (1–6) 6 no response [28]
  3. cRASS score (+ 4 to − 4) 0 to − 1: alert and calm, drowsy [29]