Volatile sedation in critically ill adults undergoing mechanical ventilation: a meta-analysis of randomized controlled trials
Contact us if these videos are not relevant.
Contact us if these videos are not relevant.
View abstract on PubMed
Summary
This summary is machine-generated.Volatile sedation may increase mortality in mechanically ventilated adults compared to intravenous sedation. Current evidence suggests limiting its use to specific clinical situations, with further research needed.
Area Of Science
- Critical Care Medicine
- Anesthesiology
- Pharmacology
Background
- Volatile sedation is explored for potential lung-protective and anti-inflammatory benefits in critically ill patients.
- Its impact on clinically relevant outcomes, such as mortality, remains uncertain.
- This meta-analysis investigates if volatile sedation improves outcomes compared to intravenous sedation.
Purpose Of The Study
- To test the hypothesis that volatile sedation reduces mortality in critically ill adults on mechanical ventilation.
- To compare volatile versus intravenous sedation in terms of mortality and other clinical outcomes.
Main Methods
- Meta-analysis of 21 randomized controlled trials (RCTs) involving 2367 patients.
- Searched MEDLINE, Embase, and Cochrane Library up to March 18, 2025.
- Primary outcome: mortality; secondary outcomes: ventilation duration, ICU/hospital stay, and adverse events. Trial sequential analysis (TSA) was performed.
Main Results
- Volatile sedation was associated with a potential increase in mortality (RR 1.17; 95% CI 1.02-1.35) with low certainty.
- TSA indicated insufficient sample size for a definitive conclusion on mortality.
- No significant effects on most secondary outcomes, except a slight reduction in time to extubation.
Conclusions
- Volatile sedation may increase mortality in mechanically ventilated critically ill adults compared to intravenous sedation.
- Current evidence suggests limiting volatile sedation to carefully selected clinical scenarios.
- Further research is required to identify specific patient groups who might benefit from volatile sedation.
Contact us if these videos are not relevant.
Contact us if these videos are not relevant.
Related Concept Videos
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
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...