Application of partial neuromuscular blockade in lung and diaphragm protective ventilation in acute respiratory distress syndrome
Implementing lung and diaphragm protective ventilation is the basic principle in positive pressure mechanical ventilation in patients with acute respiratory distress syndrome.Guidelines suggest using neuromuscular blockade agents to treat moderate to severe acute respiratory distress syndrome during the early stage to avoid vigorous spontaneous breathing,which could lead to increased driving pressure and diaphragm overload damage;however,diaphragmatic muscle disuse atrophy will be inevitable.Partial neuromuscular blockade by titration of the dose of neuromuscular blockers may keep the diaphragm active while maintaining the respiratory drive within the safe range,providing a feasible protective ventilation strategy in the lungs and diaphragm.This review aims to summarize the research status in related fields to provide guidance for current clinical practice and ideas for future research direc-tions.
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