Andreas Meiser1, Heinrich V Groesdonk1, Sarah Bonnekessel1, Thomas Volk1, Hagen Bomberg2. 1. Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg/Saar, Germany. 2. Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Center, Homburg/Saar, Germany. hagen.bomberg@uks.eu.
Abstract
INTRODUCTION: Isoflurane has shown better sedation control and potential benefits in patients with ARDS compared to propofol or midazolam, but the practical use during continuous lateral rotational therapy remains unknown. We therefore compared isoflurane with propofol and midazolam regarding sedation depth (per the Richmond Agitation-Sedation Scale), opioid consumption, lung function, and hemodynamics in patients treated with continuous lateral rotational therapy. METHODS: 38 consecutive critically ill surgical subjects were retrospectively studied using a hospital database. All subjects suffered from ARDS and were treated with continuous lateral rotational therapy between May 2010 and September 2013. Nineteen subjects were sedated with propofol or midazolam and compared with 19 subjects sedated with isoflurane using the AnaConDa-system. RESULTS: Isoflurane sedation resulted in significantly lower Richmond Agitation-Sedation Scale scores compared with propofol or midazolam. Despite deep isoflurane sedation, opioid consumption could be significantly reduced. Spontaneous breathing was possible in 90% of the subjects on isoflurane sedation compared with 16% of the subjects sedated with propofol or midazolam. The difference between peak inspiratory pressure and PEEP was significantly decreased after 24 h of isoflurane sedation. Oxygenation (PaO2 /FIO2 ) improved in both groups. Hemodynamics and need for vasopressor therapy were comparable between groups. CONCLUSIONS: This study supports the feasibility of isoflurane sedation using continuous lateral rotational therapy.
INTRODUCTION:Isoflurane has shown better sedation control and potential benefits in patients with ARDS compared to propofol or midazolam, but the practical use during continuous lateral rotational therapy remains unknown. We therefore compared isoflurane with propofol and midazolam regarding sedation depth (per the Richmond Agitation-Sedation Scale), opioid consumption, lung function, and hemodynamics in patients treated with continuous lateral rotational therapy. METHODS: 38 consecutive critically ill surgical subjects were retrospectively studied using a hospital database. All subjects suffered from ARDS and were treated with continuous lateral rotational therapy between May 2010 and September 2013. Nineteen subjects were sedated with propofol or midazolam and compared with 19 subjects sedated with isoflurane using the AnaConDa-system. RESULTS:Isoflurane sedation resulted in significantly lower Richmond Agitation-Sedation Scale scores compared with propofol or midazolam. Despite deep isoflurane sedation, opioid consumption could be significantly reduced. Spontaneous breathing was possible in 90% of the subjects on isoflurane sedation compared with 16% of the subjects sedated with propofol or midazolam. The difference between peak inspiratory pressure and PEEP was significantly decreased after 24 h of isoflurane sedation. Oxygenation (PaO2 /FIO2 ) improved in both groups. Hemodynamics and need for vasopressor therapy were comparable between groups. CONCLUSIONS: This study supports the feasibility of isoflurane sedation using continuous lateral rotational therapy.
Authors: Hagen Bomberg; Franziska Meiser; Sarah Zimmer; Martin Bellgardt; Thomas Volk; Daniel I Sessler; Heinrich V Groesdonk; Andreas Meiser Journal: J Clin Monit Comput Date: 2018-04-26 Impact factor: 2.502
Authors: Philipp Daume; Johannes Weis; Hagen Bomberg; Martin Bellgardt; Thomas Volk; Heinrich V Groesdonk; Andreas Meiser Journal: J Clin Med Date: 2021-02-09 Impact factor: 4.241
Authors: Azzeddine Kermad; Jacques Speltz; Philipp M Lepper; Andreas Meiser; Guy Danziger; Thilo Mertke; Robert Bals; Thomas Volk Journal: J Anesth Date: 2021-06-25 Impact factor: 2.078
Authors: Martin Bellgardt; Adrian Iustin Georgevici; Mitja Klutzny; Dominik Drees; Andreas Meiser; Philipp Gude; Heike Vogelsang; Thomas Peter Weber; Jennifer Herzog-Niescery Journal: Ann Intensive Care Date: 2019-10-16 Impact factor: 6.925