• Hendrik Bracht, Andreas Meiser, Jan Wallenborn, Ulf Guenther, Klaus M Kogelmann, Andreas Faltlhauser, Konrad Schwarzkopf, Jens Soukup, Tobias Becher, Patrick Kellner, Rihard Knafelj, Peter Sackey, Martin Bellgardt, and Sedaconda Study Group.
• University Hospital Bielefeld Bethel, Campus Bielefeld-Bethel, Department of Anesthesiology, Intensive Care, Emergency and Transfusion Medicine and Pain Therapy, Bielefeld, Germany. Electronic address: Hendrik.Bracht@uniklinik-ulm.de.
• J Crit Care. 2023 Dec 1; 78: 154350154350.

PurposeTo compare ICU-free (ICU-FD) and ventilator-free days (VFD) in the 30 days after randomization in patients that received isoflurane or propofol without receiving the other sedative.Materials And MethodsA recent randomized controlled trial (RCT) compared inhaled isoflurane via the Sedaconda® anaesthetic conserving device (ACD) with intravenous propofol for up to 54 h (Meiser et al. 2021). After end of study treatment, continued sedation was locally determined. Patients were eligible for this post-hoc analysis only if they had available 30-day follow-up data and never converted to the other drug in the 30 days from randomization. Data on ventilator use, ICU stay, concomitant sedative use, renal replacement therapy (RRT) and mortality were collected.ResultsSixty-nine of 150 patients randomized to isoflurane and 109 of 151 patients randomized to propofol were eligible. After adjusting for potential confounders, the isoflurane group had more ICU-FD than the propofol group (17.3 vs 13.8 days, p = 0.028). VFD for the isoflurane and propofol groups were 19.8 and 18.5 respectively (p = 0.454). Other sedatives were used more frequently (p < 0.0001) and RRT started in a greater proportion of patients in the propofol group (p = 0.011).ConclusionsIsoflurane via the ACD was not associated with more VFD but with more ICU-FD and less concomitant sedative use.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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