Continuous vs Bolus Neuromuscular Blockade Regimens in Moderate to Severe Hypoxemic Respiratory Failure and ARDS (COBRA)
Starting soon · Phase 2
Conditions studied: ARDS (Acute Respiratory Distress Syndrome)
In brief
Current clinical guidelines, such as those from the Surviving Sepsis Campaign and ARDSNet, recommend short-term NMBA use for patients with moderate to severe ARDS who exhibit persistent ventilator dyssynchrony or high plateau pressures despite deep sedation . However, they do not provide clear recommendations regarding the mode of administration. As a result, clinicians are left to extrapolate from limited or indirect evidence, which may lead to practice variation, uncertainty, and suboptimal care. This pilot randomized controlled trial is designed to directly address this critical gap by comparing intermittent bolus administration versus continuous infusion of NMBAs in a pragmatic, real-world ICU setting. The study will assess feasibility metrics necessary to plan a definitive trial and generate preliminary clinical data on safety and effectiveness. By clarifying the comparative benefits and risks of each approach, the results may influence practice guidelines, reduce variation in care, and improve patient outcomes and reduce practice variation.patient outcomes, optimize resource use, and inform future guidelines on the management of moderate to severe ARDS.
Key facts
- Study ID
- NCT07567768
- Run by
- University of Calgary
- People needed
- 100
- Starts
- 2027-01-01
- Expected to finish
- 2028-01-01
- Last updated by the study team
- 2026-05-14
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Age ≥18 years
- Mechanically ventilated and on a controlled ventilation mode
- Diagnosis of moderate to severe ARDS (PaO₂/FiO₂ ≤150 mmHg on PEEP ≥5 cm H₂O)
- Bilateral pulmonary infiltrates consistent with ARDS
- Randomized within 24 hours of meeting ARDS criteria
You may not qualify if…
- Pregnancy
- Known allergy or contraindication to rocuronium
- Neuromuscular disorders (e.g., myasthenia gravis, Guillain-Barré syndrome)
- Brain death or decision for withdrawal of life-sustaining therapy
- Enrollment in a conflicting interventional trial
Full record on ClinicalTrials.gov
Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.