Sparing in Neuromuscular Blockade in COVID 19 ICU (TOF-COVID)

Civil Hospices of Lyon

Status: Completed

Conditions: Human Characteristics; Intensive Care Unit Acquired Weakness; Complication of Medical Care; Neuromuscular Blockade

Treatments: Device: TOF protocol

Study type: Observational

Funder types: Other

Identifiers

NCT04459533

2020_TOF-COVID

Details and patient eligibility

About

This is a retrospective case-controlled study of the effect of the use of a neuromuscular blockade (NMB) monitor on the consumption of NMB agents in patients under mechanical ventilation in the context of COVID-19.

The use of NMB agents during mechanical ventilation in patients with acute respiratory distress syndrome (ARDS) improves respiratory support conditions and reduces mortality. In the context of COVID-19 pandemic, patients with severe forms of the disease hospitalized in intensive care units (ICU) benefit from prolonged mechanical ventilation with frequent use of NMB agents. Large amount of such patient admitted in a short time has led to a shortage of NMB agents, particularly cisatracurium.

The use of NMB monitors (for example - Train of Four (TOF)) is a well-established practice in general anesthesia. There is no recommendation for the use of NMB monitor in ICU patients available up to date. However, in the attempt to reduce the consumption of NMB agents a NMB monitoring was used in ICU patients during the COVID-19 pandemic at university hospitals of Hospices Civil de Lyon, with the endorsement of the local College of Anesthetists.

The aim of our study is to evaluate if the use of a NMB monitor decreases the consumption of NMB agents in patients under mechanical ventilation in the context of COVID-19.

Enrollment: 250 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• PCR-proven SARS-CoV-2 infection
• Use of VM (mechanical ventilation)
• Use of NMB agents for at least 48 hours

Exclusion criteria

• Pregnancy
• extracorporeal membrane oxygenation (ECMO)

Trial design

250 participants in 2 patient groups

TOF group

Description:

COVID-19 patients admitted to the ICU, receiving mechanical ventilation and NMB agents, for whom a NMB monitor use (TOF) was reported in the electronic health records (EHR).

Treatment:

Device: TOF protocol

Control group

Description:

COVID-19 patients admitted to the ICU, receiving mechanical ventilation and NMB agents, with no NMB monitor use reported in the EHR