Volatile Sedation for Acute Respiratory Distress Syndrome Patients on Venovenous Extracorporeal Membrane Oxygenation and Ultraprotective Ventilation.
acute respiratory distress syndrome
extracorporeal membrane oxygenation
isoflurane; ultraprotective ventilation
volatile sedation
Journal
Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
entrez:
18
1
2021
pubmed:
19
1
2021
medline:
19
1
2021
Statut:
epublish
Résumé
Patients on extracorporeal support for severe acute respiratory distress syndrome may require a prolonged period of deep sedation. In these patients, volatile sedation may represent a valid alternative to IV drugs. The aim of our study was to describe the feasibility of volatile sedation in a large cohort of acute respiratory distress syndrome patients undergoing venovenous extracorporeal membrane oxygenation and ultraprotective ventilation. Retrospective monocentric study. Adult ICU, ASST Monza, Italy. Adult patients who underwent volatile sedation with isoflurane during venovenous extracorporeal membrane oxygenation between 2009 and 2019. Isoflurane was delivered via the AnaConDa system. The sedation level, hemodynamics, and laboratory tests were compared between the volatile sedation phase and the IV sedation phases before and after the isoflurane sedation period. About 74 patients (50 yr [43-56 yr]) were included. Median duration of venovenous extracorporeal membrane oxygenation support was 22 days (14-51 d). Volatile sedation started on day 3 (2-6) of extracorporeal membrane oxygenation support, and its median duration was 7 days (4-13 d), ranging from 1 to 38 days. A total of 970 venovenous extracorporeal membrane oxygenation days were analyzed. During the volatile phase, the sedation level was slightly deeper (bispectral index 39 ± 6) compared with the IV phase before and after isoflurane (42 ± 8 and 43 ± 9, respectively, Volatile sedation represents an alternative to IV agents to achieve long-term deep sedation in critically ill patients on extracorporeal membrane oxygenation undergoing ultraprotective ventilation.
Identifiants
pubmed: 33458679
doi: 10.1097/CCE.0000000000000310
pmc: PMC7803679
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0310Informations de copyright
Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Déclaration de conflit d'intérêts
The authors have disclosed that they do not have any potential conflicts of interest.
Références
ASAIO J. 2018 Jul/Aug;64(4):544-551
pubmed: 29045280
Respir Care. 2008 Oct;53(10):1295-303
pubmed: 18811990
Perfusion. 2005 Oct;20(6):309-15
pubmed: 16363315
Med Klin Intensivmed Notfmed. 2017 May;112(4):352-355
pubmed: 27530768
Eur J Anaesthesiol. 1991 Jan;8(1):21-7
pubmed: 1678701
Medicine (Baltimore). 2017 Dec;96(49):e8976
pubmed: 29245269
Anesth Analg. 2017 Apr;124(4):1190-1199
pubmed: 27828800
Intensive Care Med. 2009 Jul;35(7):1240-6
pubmed: 19189080
Anaesth Intensive Care. 2010 May;38(3):555-9
pubmed: 20514968
J Crit Care. 2009 Dec;24(4):535-44
pubmed: 19327951
Eur Rev Med Pharmacol Sci. 2012 May;16(5):660-6
pubmed: 22774408
Br J Anaesth. 2019 Apr;122(4):448-459
pubmed: 30857601
J Thorac Dis. 2018 Jan;10(1):190-195
pubmed: 29600048
Am J Respir Crit Care Med. 2002 Nov 15;166(10):1338-44
pubmed: 12421743
Am J Respir Crit Care Med. 2017 Mar 15;195(6):792-800
pubmed: 27611637
Crit Care. 2015 Nov 12;19:398
pubmed: 26558513
Crit Care. 2014 Feb 26;18(2):411
pubmed: 24602556
Ger Med Sci. 2015 Nov 12;13:Doc19
pubmed: 26609286
Crit Care. 2016 Mar 16;20:66
pubmed: 26984504
Crit Care Med. 2018 Sep;46(9):e825-e873
pubmed: 30113379
AACN Adv Crit Care. 2018 Fall;29(3):246-258
pubmed: 30185491
J Artif Organs. 2018 Jun;21(2):201-205
pubmed: 29508167
Anaesth Crit Care Pain Med. 2018 Dec;37(6):551-556
pubmed: 29455032
Intensive Care Med. 1997 Sep;23(9):969-74
pubmed: 9347369
Crit Care Med. 1997 Jan;25(1):33-40
pubmed: 8989173
Pharmacotherapy. 2016 Jun;36(6):607-16
pubmed: 27130442
Crit Care Med. 2004 Nov;32(11):2241-6
pubmed: 15640636
Drugs. 2012 Oct 1;72(14):1881-916
pubmed: 22950534
Crit Care Med. 1999 Aug;27(8):1499-504
pubmed: 10470756
ASAIO J. 2017 Mar/Apr;63(2):174-178
pubmed: 27832000
Anesth Analg. 2017 Oct;125(4):1235-1239
pubmed: 28301417
Intensive Care Med. 2012 Dec;38(12):1955-64
pubmed: 23096426
Crit Care. 2017 Mar 21;21(1):66
pubmed: 28320466