- Pharmacology
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Inhalation sedation for postoperative patients in the intensive care unit: initial sevoflurane concentration and comparison of opioid use with propofol sedation
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Seungho Jung, Sungwon Na, Hye Bin Kim, Hye Ji Joo, Jeongmin Kim
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Acute Crit Care. 2020;35(3):197-204. Published online August 10, 2020
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DOI: https://doi.org/10.4266/acc.2020.00213
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Abstract
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- Background
Although the use of volatile sedatives in the intensive care unit (ICU) is increasing in Europe, it remains infrequent in Asia. Therefore, there are no clinical guidelines available. This study investigates the proper initial concentration of sevoflurane, a volatile sedative that induces a Richmond agitation-sedation scale (RASS) score of –2 to –3, in patients who underwent head and neck surgery with tracheostomy. We also compared the amount of postoperative opioid consumption between volatile and intravenous (IV) sedation.
Methods We planned a prospective study to determine the proper initial sevoflurane concentration and a retrospective analysis to compare postoperative opioid consumption between volatile sedation and propofol sedation. Patients scheduled for head and neck surgery with tracheostomy and subsequent postoperative sedation in the ICU were enrolled.
Results In this prospective study, the effective dose 50 (ED50) of initial end-tidal sevoflurane concentration was 0.36% (95% confidence interval [CI], 0.20 to 0.60%), while the ED 95 was 0.69% (95% CI, 0.60 to 0.75%) based on isotonic regression methods. In this retrospective study, remifentanil consumption during postoperative sedation was significantly lower in the sevoflurane group (2.52±1.00 µg/kg/hr, P=0.001) than it was in the IV propofol group (3.66±1.30 µg/kg/hr).
Conclusions We determined the proper initial end-tidal concentration setting of sevoflurane for patients with tracheostomy who underwent head and neck surgery. Postoperative sedation with sevoflurane appears to be a valid and safe alternative to IV sedation with propofol.
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Citations
Citations to this article as recorded by
- Volatile Anesthetic Sedation for Critically Ill Patients
Brian O’Gara, Christina Boncyk, Andreas Meiser, Angela Jerath, Martin Bellgardt, Matthieu Jabaudon, Jeremy R. Beitler, Christopher G. Hughes Anesthesiology.2024; 141(1): 163. CrossRef - Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysis
V. Likhvantsev, G. Landoni, N. Ermokhina, M. Yadgarov, L. Berikashvili, K. Kadantseva, O. Grebenchikov, L. Okhinko, A. Kuzovlev Medicina Intensiva.2023; 47(5): 267. CrossRef - Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysis
V. Likhvantsev, G. Landoni, N. Ermokhina, M. Yadgarov, L. Berikashvili, K. Kadantseva, O. Grebenchikov, L. Okhinko, A. Kuzovlev Medicina Intensiva (English Edition).2023; 47(5): 267. CrossRef - Inhaled Sedation with Volatile Anesthetics for Mechanically Ventilated Patients in Intensive Care Units: A Narrative Review
Khaled Ahmed Yassen, Matthieu Jabaudon, Hussah Abdullah Alsultan, Haya Almousa, Dur I Shahwar, Fatimah Yousef Alhejji, Zainab Yaseen Aljaziri Journal of Clinical Medicine.2023; 12(3): 1069. CrossRef - Sedation with Sevoflurane versus Propofol in COVID-19 Patients with Acute Respiratory Distress Syndrome: Results from a Randomized Clinical Trial
Sara Martínez-Castro, Berta Monleón, Jaume Puig, Carolina Ferrer Gomez, Marta Quesada, David Pestaña, Alberto Balvis, Emilio Maseda, Alejandro Suárez de la Rica, Ana Monero Feijoo, Rafael Badenes Journal of Personalized Medicine.2023; 13(6): 925. CrossRef - Effect of inhaled anaesthetics on cognitive and psychiatric outcomes in critically ill adults: a systematic review and meta-analysis
Sean Cuninghame, Angela Jerath, Kevin Gorsky, Asaanth Sivajohan, Conall Francoeur, Davinia Withington, Lisa Burry, Brian H. Cuthbertson, Beverley A. Orser, Claudio Martin, Adrian M. Owen, Marat Slessarev, Martin Chapman, Damon Scales, Julie Nardi, Beth Li British Journal of Anaesthesia.2023; 131(2): 314. CrossRef - Experiencia y revisión de la literatura del uso del dispositivo Anesthetic Conserving Device (AnaConDa) durante la pandemia en pacientes con neumonía por COVID-19 en un hospital público
María Guadalupe Morales Hernández, Marcelo Díaz Conde, Ixchel Magaña Matienzo Medicina Crítica.2023; 37(4): 334. CrossRef - Sedation of patients in intensive care units. Guidelines
V.I. Potievskaya, I.B. Zabolotskikh, I.E. Gridchik, A.I. Gritsan, A.A. Eremenko, I.A. Kozlov, A.L. Levit, V.A. Mazurok, I.V. Molchanov Anesteziologiya i reanimatologiya.2023; (5): 6. CrossRef - Inhaled volatile anesthetics in the intensive care unit
Erin D Wieruszewski, Mariam ElSaban, Patrick M Wieruszewski, Nathan J Smischney World Journal of Critical Care Medicine.2023;[Epub] CrossRef - Prospects of inhalation sedation in intensive care
O.A. Grebenchikov, V.V. Kulabukhov, A.K. Shabanov, O.V. Ignatenko, V.V. Antonova, R.A. Cherpakov, I.V. Redkin, E.A. Boeva, A.N. Kuzovlev Anesteziologiya i reanimatologiya.2022; (3): 84. CrossRef - Análisis nacional de la sedación aplicada en pacientes de cuidados críticos
Grace Pamela López Pérez, Melani Dayana Carrera Casa, Gissela Lizbeth Amancha Moyulema, Yadira Nathaly Chicaiza Quilligana, Ana Belén Guamán Tacuri, Joselyn Mireya Iza Arias Salud, Ciencia y Tecnología.2022; 2(S1): 234. CrossRef
- Neurology
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The Effect of Electrical Muscle Stimulation and In-bed Cycling on Muscle Strength and Mass of Mechanically Ventilated Patients: A Pilot Study
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Kyeongyoon Woo, Jeongmin Kim, Hye Bin Kim, Hyunwoo, Choi, Kibum Kim, Donghyung Lee, Sungwon Na
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Acute Crit Care. 2018;33(1):16-22. Published online February 14, 2017
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DOI: https://doi.org/10.4266/acc.2017.00542
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9,559
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341
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12
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Abstract
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- Background
Critically ill patients experience muscle weakness, which leads to functional disability. Both functional electrical stimulation (FES) and in-bed cycling can be an alternative measure for intensive care unit (ICU) patients who are not feasible for active exercise. The aim of this study was to examine whether FES and in-bed cycling have a positive effect on muscle mass in ICU patients.
Methods Critically ill patients who received mechanical ventilation for at least 24 hours were included. After passive range of motion exercise, in-bed cycling was applied for 20 minutes, and FES was applied for 20 minutes on the left leg. The right leg received in-bed cycling and the left leg received both FES and in-bed cycling. Thigh circumferences and rectus femoris cross-sectional area (CSA) were assessed with ultrasonography before and after the intervention. Muscle strength was assessed by Medical Research Council scale.
Results A total of 10 patients were enrolled in this study as a pilot study. Before and after the intervention, the CSA of right rectus femoris increased from 5.08 ± 1.51 cm2 to 6.01 ± 2.21 cm2 , which was statistically significant (P = 0.003). The thigh circumference was also increased and statistically significant (P = 0.006). There was no difference between left and right in regard to FES application. There is no significant change in muscle strength before and after the intervention (right and left, P = 0.317 and P = 0.368, respectively).
Conclusions In-bed cycling increased thigh circumferences rectus femoris CSA. Adding FES did not show differences.
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Citations
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Júlia Lima, Estéfani Foletto, Rafaella C.B. Cardoso, Charlles Garbelotto, Aline P. Frenzel, Juliana U. Carneiro, Larissa S. Carpes, Thiago G. Barbosa-Silva, Maria Cristina Gonzalez, Flávia M. Silva Clinical Nutrition.2024; 43(1): 95. CrossRef - Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology
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Hyung Ik Shin Annals of CardioPulmonary Rehabilitation.2021; 1(1): 17. CrossRef - Rehabilitation Programs for Bedridden Patients with Prolonged Immobility: A Scoping Review Protocol
Vitor Parola, Hugo Neves, Filipa Margarida Duque, Rafael A. Bernardes, Remy Cardoso, Carla A. Mendes, Liliana B. Sousa, Paulo Santos-Costa, Cândida Malça, Rúben Durães, Pedro Parreira, João Apóstolo, Arménio Cruz International Journal of Environmental Research and Public Health.2021; 18(22): 12033. CrossRef - Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke
Masafumi Nozoe, Masashi Kanai, Hiroki Kubo, Miho Yamamoto, Shinichi Shimada, Kyoshi Mase Journal of Clinical Neuroscience.2020; 74: 141. CrossRef - Intensive Care Unit-Acquired Weakness: Not Just Another Muscle Atrophying Condition
Heta Lad, Tyler M. Saumur, Margaret S. Herridge, Claudia C. dos Santos, Sunita Mathur, Jane Batt, Penney M. Gilbert International Journal of Molecular Sciences.2020; 21(21): 7840. CrossRef - Problems with Rehabilitation for Critically ill Patients
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