Sevoflorane as adjuvant for sedation during mechanical ventilation in intensive care unit medical patients: Preliminary results of a series of cases
Keywords:
Anesthesia inhalation, Midazolam, Intensive care, Artificial Respiration, Conscious sedation
Abstract
Objective: To disclose our preliminary experience in inhalation sedation with sevoflorane in a standardized manner using the Anesthetic Conserving Device in intubated, critically ill patients in our ICU.
Patients: It has been used in nine cases of adult patients, six men and three women, over 24 months.
Results: A proper implementation of the protocol by physicians and the nursing staff has been achieved, meeting the goals established for sedation (RASS 0, -2) free of hepatic or renal adverse outcomes or side effects.
Conclusions: In our limited experience, adjuvant inhalation sedation with sevoflorane in the ICU is safe and complementary to the use of intravenous drugs such as propofol, remifentanil and midazolam, which are currently commonly used to achieve goal-directed sedation.
References
1. Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30:119-41.
2. Shapiro BA, Warren J, Egol AB, Greenbaum DM, Jacobi J, Nasraway SA, et al. Practice parameters for intravenous analgesia and sedation for adult patient in the intensive care unit. Crit Care Med. 1995;23:1596-600.
3. Martin J, Básell K, Bürkle H, Hommel J, Huth H, Kessler P, et al. Analgesia and sedation in ICU-S2 guidelines of DGAI. Anaesthesiologie und Intensivmedizin. 2005;46: S1-20.
4. Kong KL, Willatts SM. Inorganic isoflorane compared with midazolam for sedation in the intensive care unit. BJM. 1989;298:1277-80.
5. Werner C, Mõllenberg O, Kochs E, Esch JS. Sevoflorane improves neurological outcome after incomplete cerebral ischemia in rats. BJA. 1985;75:756-60.
6. Sesler CN, Grap MJ, Brophy GM. Multidisciplinary managemen and analgesia in critical care. Semin Respir Crit Care Med. 2001;22:211-25.
7. Enlund M, Wiklund L, Lambert H. A new device to reduce the consumption of a halogenated anaesthetic agent. Anaesthesia. 2001;56:482-6.
8. Prieto Vera CJ, Macias Pingarron JP, Asensio Moreno A, Andujar Quiros B, Gragera Collado I. Experiencia clinica del sistema AnaConDa en una unidad de reanimación de cirugía cardiaca. Rev Esp Anestesiol Reanim. 2011;58:421-5.
9. Rohm KD, Wolf MW, Schõlhorn T, Schellhaass A, Boldt J, Piper SN. Short term sevoflorano sedation using the anaesthethic conserving device after cardiothoracic surgery. Intensive Care Med. 2008;34:1683-9.
10. Mesnil M, Capdevila X, Bringuier S, Trine PO, Falquet Y, Charbit J, et al. Long term sedation in intensive care unit: a randomized comparison between inhaled sevoflorane and intravenous propofol or midazolam. Intensive Care Med. 2011;37:933-41.
11. Rhõm D, Mengistu A, Boldt J, mayer J, Beck G, Piper SN. Renal integrity in sevoflorane sedation in the intensive care unit with the anesthetic-conserving device: a comparison with intravenous propofol sedation. Anesth Analg. 2009;108:1848-54.
12. Fink EJ Jr, Ghanthous H, Malan TP, Morgan S, Fernando J, Gandolfi AJ, et al. Plasma inorganic fluoride with sevoflorane anesthesia: correlation with indices of hepatic and renal function. Anesth Analg. 1992;74:231-5.
13. Belda JF, Soro M, Badenes R, Meiser A, Garcia ML, Aguilar G, et al. The predictive performance of a pharmacokinetic model for manually adjusted infusion of liquid sevoflorane for use with the Anesthetic-Conserving Device (AnaConDa): a clinical study. Anesth Analg. 2008;106:1207-14.
14. Candia Arana CA, Castillo Monzón CG, Alvárez Gómez JA, Roca González J, Eslava Schmalbach JH. Desempeño predictivo y clinico de un dispositivo targed-controlled infusión para sevoflorano en una estación de trabajo convencional: correlación farmacocinética del modelo empleado. Rev Colom Anestesiol. 2014;42:255-64.
2. Shapiro BA, Warren J, Egol AB, Greenbaum DM, Jacobi J, Nasraway SA, et al. Practice parameters for intravenous analgesia and sedation for adult patient in the intensive care unit. Crit Care Med. 1995;23:1596-600.
3. Martin J, Básell K, Bürkle H, Hommel J, Huth H, Kessler P, et al. Analgesia and sedation in ICU-S2 guidelines of DGAI. Anaesthesiologie und Intensivmedizin. 2005;46: S1-20.
4. Kong KL, Willatts SM. Inorganic isoflorane compared with midazolam for sedation in the intensive care unit. BJM. 1989;298:1277-80.
5. Werner C, Mõllenberg O, Kochs E, Esch JS. Sevoflorane improves neurological outcome after incomplete cerebral ischemia in rats. BJA. 1985;75:756-60.
6. Sesler CN, Grap MJ, Brophy GM. Multidisciplinary managemen and analgesia in critical care. Semin Respir Crit Care Med. 2001;22:211-25.
7. Enlund M, Wiklund L, Lambert H. A new device to reduce the consumption of a halogenated anaesthetic agent. Anaesthesia. 2001;56:482-6.
8. Prieto Vera CJ, Macias Pingarron JP, Asensio Moreno A, Andujar Quiros B, Gragera Collado I. Experiencia clinica del sistema AnaConDa en una unidad de reanimación de cirugía cardiaca. Rev Esp Anestesiol Reanim. 2011;58:421-5.
9. Rohm KD, Wolf MW, Schõlhorn T, Schellhaass A, Boldt J, Piper SN. Short term sevoflorano sedation using the anaesthethic conserving device after cardiothoracic surgery. Intensive Care Med. 2008;34:1683-9.
10. Mesnil M, Capdevila X, Bringuier S, Trine PO, Falquet Y, Charbit J, et al. Long term sedation in intensive care unit: a randomized comparison between inhaled sevoflorane and intravenous propofol or midazolam. Intensive Care Med. 2011;37:933-41.
11. Rhõm D, Mengistu A, Boldt J, mayer J, Beck G, Piper SN. Renal integrity in sevoflorane sedation in the intensive care unit with the anesthetic-conserving device: a comparison with intravenous propofol sedation. Anesth Analg. 2009;108:1848-54.
12. Fink EJ Jr, Ghanthous H, Malan TP, Morgan S, Fernando J, Gandolfi AJ, et al. Plasma inorganic fluoride with sevoflorane anesthesia: correlation with indices of hepatic and renal function. Anesth Analg. 1992;74:231-5.
13. Belda JF, Soro M, Badenes R, Meiser A, Garcia ML, Aguilar G, et al. The predictive performance of a pharmacokinetic model for manually adjusted infusion of liquid sevoflorane for use with the Anesthetic-Conserving Device (AnaConDa): a clinical study. Anesth Analg. 2008;106:1207-14.
14. Candia Arana CA, Castillo Monzón CG, Alvárez Gómez JA, Roca González J, Eslava Schmalbach JH. Desempeño predictivo y clinico de un dispositivo targed-controlled infusión para sevoflorano en una estación de trabajo convencional: correlación farmacocinética del modelo empleado. Rev Colom Anestesiol. 2014;42:255-64.
How to Cite
1.
López-Ramos JM, Gómez-Sainz JJ, Manzano-Canalechevarria A, Aguilera-Celorrio L. Sevoflorane as adjuvant for sedation during mechanical ventilation in intensive care unit medical patients: Preliminary results of a series of cases. Colomb. J. Anesthesiol. [Internet]. 2016 Jan. 1 [cited 2024 Apr. 24];44(1):52-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/71
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Published
2016-01-01
How to Cite
1.
López-Ramos JM, Gómez-Sainz JJ, Manzano-Canalechevarria A, Aguilera-Celorrio L. Sevoflorane as adjuvant for sedation during mechanical ventilation in intensive care unit medical patients: Preliminary results of a series of cases. Colomb. J. Anesthesiol. [Internet]. 2016 Jan. 1 [cited 2024 Apr. 24];44(1):52-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/71
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Section
Case Report / Case Series
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