• Medicina · Jan 2024

    Sedation with inhaled sevoflurane in the intensive care unit.

    • Indalecio Carboni Bisso, Maria Florencia Courtois, Marcela Bono, Iván Huespe, Gisela Vecchio, Ignacio Fernández Ceballos, Gustavo Bongiorni, and Marcos Las Heras.
    • Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. E-mail: indalecio.carbonibisso@hospitalitaliano.org.ar.
    • Medicina (B Aires). 2024 Jan 1; 84 (4): 672681672-681.

    IntroductionCritically ill patients often develop the Post-Intensive Care Syndrome (PICS). Current sedation guidelines mainly rely on intravenous agents. Inhaled sedatives are a promising alternative with favorable pharmacokinetics and potential benefits in critical care settings. However, their application in Latin America remains unexplored.MethodsCase-series study that included adult ICU patients who underwent deep sedation with sevoflurane using the SEDANA anesthetic conserving device. Data on demographics, sedation protocols, adverse events, and outcomes were collected. Statistical analysis assessed changes over time in laboratory parameters.ResultsEleven patients were included, with sevoflurane administered via artificial airways. Inhaled sedation led to the successful cease of intravenous sedatives in 10 of 11 patients, and reduction of at least 30% in opioid dose. No significant adverse effects were observed. Barriers to adherence included device-related issues and challenges in healthcare staff training.ConclusionSevoflurane effectively achieved sedation goals in ICU patients, reducing the need for additional sedatives and opioids. Our findings support the safety and efficacy of inhaled sedatives in ICU settings and highlight the importance of further research in this area. Longer-term studies are needed to fully determine the impact of inhaled sedatives in ICU patients.

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