Acute and Critical Care

Original Articles

Pharmacology
Inhalation sedation for postoperative patients in the intensive care unit: initial sevoflurane concentration and comparison of opioid use with propofol sedation: Seungho Jung, Sungwon Na, Hye Bin Kim, Hye Ji Joo, Jeongmin Kim; Acute Crit Care. 2020;35(3):197-204. Published online August 10, 2020; DOI: https://doi.org/10.4266/acc.2020.00213

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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.

Citations

Citations to this article as recorded by

Alpha-lipoic acid alleviates oxidative stress and brain damage in patients with sevoflurane anesthesia
Kailun Gao, Ying Wu, Yan Zhang, Pei Dang, Huanjia Xue, Teng Li, Meiyan Zhou, Liwei Wang, Yangzi Zhu
Frontiers in Pharmacology.2025;[Epub] CrossRef
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
Sedaconda ACD-S for Sedation with Volatile Anaesthetics in Intensive Care: A NICE Medical Technologies Guidance
Michal Pruski, Susan O’Connell, Laura Knight, Rhys Morris
Applied Health Economics and Health Policy.2024; 22(6): 805. CrossRef
The sevoflurane concentration for light sedation in critically ill patients: A protocol for experimental study
Wilasinee Jitpakdee, Chawika Pisitsak, Sunthiti Morakul, Sahawat Thertchanakun, Tananchai Petnak
Clinical Critical Care.2024;[Epub] 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
National analysis of applied sedation in critical care patients
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: 234. CrossRef

Neurology
The Effect of Electrical Muscle Stimulation and In-bed Cycling on Muscle Strength and Mass of Mechanically Ventilated Patients: A Pilot Study: Kyeongyoon Woo, Jeongmin Kim, Hye Bin Kim, Hyunwoo, Choi, Kibum Kim, Donghyung Lee, Sungwon Na; Acute Crit Care. 2018;33(1):16-22. Published online February 14, 2017; DOI: https://doi.org/10.4266/acc.2017.00542

10,959 View
353 Download
14 Web of Science
14 Crossref

Abstract PDF

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.

Citations

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Assisted mobilisation in critical patients with COVID-19
M. Polastri, F. Daniele, F. Tagariello
Pulmonology.2024; 30(2): 152. CrossRef
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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
Thaís Ferreira Lopes Diniz Maia, Paulo André Freire Magalhães, Dasdores Tatiana Silva Santos, Jorge Luiz de Brito Gomes, Paulo Adriano Schwingel, Aline de Freitas Brito
Neurocritical Care.2024; 41(1): 272. CrossRef
Anabolic Strategies for ICU-Acquired Weakness. What Can We Learn from Bodybuilders?
Jakub Tarnawski, Maja Czub, Marta Dymecki, Medha Sunil, Marcin Folwarski
Nutrients.2024; 16(13): 2011. CrossRef
Methodologies and clinical applications of lower limb muscle ultrasound in critically ill patients: a systematic review and meta-analysis
Roberto Venco, Alessandro Artale, Paolo Formenti, Cristian Deana, Giovanni Mistraletti, Michele Umbrello
Annals of Intensive Care.2024;[Epub] CrossRef
Evaluating Muscle Mass Changes in Critically Ill Patients: Rehabilitation Outcomes Measured by Ultrasound and Bioelectrical Impedance
Mijoo Kim, Soyun Kim, Yerin Ju, Soyoung Ahn, Song I Lee
Healthcare.2024; 12(21): 2128. CrossRef
Combining High Protein Intake with Early Physical Exercise During Critical Illness to Maintain Muscle Mass in Intensive Care Unit Patients: A Prospective, Randomized Controlled Study
Asmaa Badr Eldin Opoda, Sohair Moustafa Soliman, Mona Blough El Mourad Fayad, Taysser Mahmoud Abdulrahim
Bali Journal of Anesthesiology.2024; 8(4): 215. CrossRef
Human skeletal muscle size with ultrasound imaging: a comprehensive review
Masatoshi Naruse, Scott Trappe, Todd A. Trappe
Journal of Applied Physiology.2022; 132(5): 1267. CrossRef
Rehabilitation Therapy after the COVID-19 Era: Focused on Cardiopulmonary Rehabilitation
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
Masaji Nishimura
The Japanese Journal of Rehabilitation Medicine.2019; 56(1): 48. CrossRef
Exploring the Potential Effectiveness of Combining Optimal Nutrition With Electrical Stimulation to Maintain Muscle Health in Critical Illness: A Narrative Review
Selina M. Parry, Lee‐anne S. Chapple, Marina Mourtzakis
Nutrition in Clinical Practice.2018; 33(6): 772. CrossRef

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