Inhaled sedation with sevoflurane in critically ill children during extracorporeal membrane oxygenation

Area of Science:

• Pediatric Critical Care Medicine
• Anesthesiology
• Cardiopulmonary Support

Background:

• Sedation in critically ill children presents unique challenges, especially during extracorporeal membrane oxygenation (ECMO).
• Inhaled anesthetics like sevoflurane are effective for sedation but their use outside the operating room, particularly in pediatric ECMO patients, is not well-documented.
• Limited data exists on sevoflurane's safety and efficacy in pediatric patients requiring ECMO.

Observation:

• This study assessed sevoflurane's effectiveness and safety in two pediatric patients undergoing ECMO.
• Continuous monitoring was performed during sevoflurane administration and withdrawal.
• The feasibility of spontaneous breathing efforts during deep sedation was evaluated.

Findings:

• Sevoflurane successfully achieved adequate sedation in both pediatric ECMO patients.
• Patients maintained the ability to contribute to breathing despite deep sedation.
• No adverse events or side effects were noted during sevoflurane treatment or after its discontinuation.

Implications:

• Sevoflurane may be a viable and safe option for sedating pediatric patients on ECMO.
• This approach could potentially improve patient comfort and management in complex critical care scenarios.
• Further research is warranted to explore sevoflurane's broader application in pediatric intensive care settings beyond the OR.