• Christelle Teiten, Pierre Bailly, Jean-Marie Tonnelier, Laetitia Bodenes, Kahaia de Longeaux, and Erwan L'Her.
• Médecine Intensive Réanimation, CHU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France.
• Resuscitation. 2024 Aug 13: 110358110358.

RationalePoor neurological outcome is common following a cardiac arrest. The use of volatile anesthetic agents has been proposed during post-resuscitation to improve outcome.ObjectivesTo determine the effects of inhaled isoflurane on neurological outcome, delirium incidence, ICU length-of-stay, ventilation duration, mortality during post-resuscitation care of ICU patients.Patients510 patients were admitted within our medical ICU following a cardiac arrest during the study period, 401 of them being sedated using intravenous sedation prior to 2017 and 109 of them using inhaled isoflurane according to a standardized protocol following 2017.ResultsMatched-pair analysis depicted a delirium incidence decrease, without improved neurologic outcome on ICU discharge (CPC ≤ 2) for isoflurane patients (16.1% vs 32.2%, p 0.03 and 29% vs 23%, p 0.47, respectively). Ventilation duration and ICU length of stay were shorter for isoflurane patients (78 vs 167 h, p 0.01 and 7.9 vs 8.5 days, p 0.01 respectively). Isoflurane had no impact on mortality.ConclusionIn this propensity-matched control study, isoflurane sedation during the post-resuscitation care of ICU patients was associated with a lower incidence of delirium, a shorter duration of mechanical ventilation and a reduced ICU length of stay. Prospective data are needed before its widespread use.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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