ROSE

Re-evaluation of Systemic Early Neuromuscular Blockade

Patient / Population Intervention / Exposure Comparison Outcome

In 1,006 patients with moderate–severe ARDS on high PEEP, early cisatracurium did not reduce 90-day mortality versus light sedation.

1,006

Design

Multicentre RCT, PETAL Network; stopped early for futility

Endpoint

90-day in-hospital mortality

Relevance

Result42.5% vs 42.8% (Δ −0.3%; p=0.93).

PETAL Clinical Trials Network. N Engl J Med. 2019;380(21):1997-2008. 10.1056/NEJMoa1901686

Discussion & critique

Reserve NMB for refractory dyssynchrony; routine paralysis is no longer indicated.