Paediatric Ards Neuromuscular Blockade Study (PAN)

  • End date
    May 1, 2024
  • participants needed
  • sponsor
    University Medical Center Groningen
Updated on 21 February 2022
mechanical ventilation
fluid overload
chest radiograph
acute respiratory distress
positive end expiratory pressure
neuromuscular blocking agents
ventilator-induced lung injury
assisted breathing


Paediatric acute respiratory distress syndrome (ARDS) is a manifestation of severe, life-threatening lung injury. Care for paediatric patient is mainly supportive and based on what works in adults and personal experiences, including the use of mechanical ventilation. However, differences in lung physiology and immunology between (young) children and adults suggests that adaptation of adult practices into paediatrics may not be justified. A study in adults with severe ARDS showed that early use of neuromuscular blocking agents (NMBA) improved 90-day survival and increased time off the ventilator without increasing muscle weakness. It is unknown if this is also true for paediatric ARDS

Condition ARDS
Treatment Isotonic saline, Neuromuscular blocking agents
Clinical Study IdentifierNCT02902055
SponsorUniversity Medical Center Groningen
Last Modified on21 February 2022


Yes No Not Sure

Inclusion Criteria

Informed consent
Age younger than 5 years
Need for mechanical ventilation with tidal volume 5 - 8 mL/kg ideal bodyweight and PEEP equal to or greater than 5 cmH2O
Early moderate - to - severe paediatric acute respiratory distress syndrome originating from any cause, i.e. acute onset of disease, and oxygenation index greater than 12, and one or more (bilateral) infiltrates on chest radiograph, and no evidence of left ventricular failure or fluid overload, and within the first 48 hours of PICU admission
Sedation defined by Comfort - B scale between 9 - 12

Exclusion Criteria

No informed consent
Known allergy or intolerance to rocuronium
Continuous administration of neuromuscular blockade prior at the time of meeting the criteria for PARDS
Chronic respiratory failure on home ventilation
Intracranial hypertension
Bone marrow transplantation
Immunocompromised patients (congenital or acquired)
Pre-existing pulmonary hypertension
Congenital heart disease with left - to - right shunting
Cyanotic congenital heart disease
Expected duration of mechanical ventilation less than 48 hours
Withdrawal of life - sustaining treatment
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