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Related Concept Videos

Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

276
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
276
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

137
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
137
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  9. Predictive And Prognostic Markers
  11. Early Sevoflurane Sedation In Severe Covid-19-related Lung Injury Patients. A Pilot Randomized Controlled Trial.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Early Sevoflurane Sedation In Severe Covid-19-related Lung Injury Patients. A Pilot Randomized Controlled Trial.

Related Experiment Video

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Early sevoflurane sedation in severe COVID-19-related lung injury patients. A pilot randomized controlled trial.

Beatrice Beck-Schimmer1,2, Erik Schadde2,3, Urs Pietsch4

  • 1Institute of Anesthesiology, University Hospital Zurich University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.

Annals of Intensive Care
|March 27, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Sevoflurane sedation did not improve mortality or organ dysfunction in COVID-19 patients. However, it reduced vasopressor use but increased acute kidney injury, suggesting caution.

Keywords:
Anesthetic conditioningCOVID-19-related lung injurySevofluraneVolatile anesthetics

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Area of Science:

  • Critical Care Medicine
  • Anesthesiology
  • Infectious Diseases

Background:

  • Severe COVID-19 lung injury involves inflammation and cytokine storms, particularly elevated IL-6.
  • Mechanical ventilation and sedation are standard treatments for these patients.

Purpose of the Study:

  • To assess the organ-protective effects of volatile sedation (sevoflurane) versus intravenous sedation in severe COVID-19 patients.
  • To evaluate the impact on mortality, persistent organ dysfunction, and inflammatory markers.

Main Methods:

  • A pilot multicenter randomized controlled trial involving 60 mechanically ventilated COVID-19 patients.
  • Patients were randomized to 48-hour sevoflurane or continuous intravenous sedation.
  • The primary outcome was mortality or persistent organ dysfunction at day 28.

Main Results:

  • No significant difference in the primary outcome (mortality or persistent organ dysfunction) between sevoflurane and control groups.
  • Sevoflurane use was associated with a significantly lower need for vasopressors (4% vs. 26%).
  • However, sevoflurane significantly increased the incidence of acute kidney injury (39% vs. 6%).

Conclusions:

  • Short-term sevoflurane sedation showed no benefit for mortality or persistent organ dysfunction in COVID-19 patients.
  • Unexpectedly low IL-6 levels suggest the inflammatory response may have been less severe than anticipated.
  • The increased risk of acute kidney injury necessitates caution when using sevoflurane for sedation in this patient population.