Sedation with sufentanil in patients receiving pressure support ventilation has no effects on respiration: a pilot study.
OBJECTIVE
To evaluate the effects of sedation with sufentanil on respiratory drive, respiratory pattern, and gas exchange of critically ill patients during pressure support ventilation.


METHODS
In this prospective observational cohort study, we observed 12 adult patients receiving partial ventilatory support for acute respiratory failure. Each subject received a continuous infusion of sufentanil at 0.2 to 0.3 micro g x kg(-1) x hr(-1) to obtain a modified Ramsay sedation score between 2 and 3. In basal conditions and at variable distance from the beginning of the sufentanil infusion (10', 30', 60', 120', 24 hr) we evaluated gas exchange, hemodynamic variables, respiratory rate (RR), tidal volume (TV), respiratory pattern, respiratory drive (P0.1) and inspiratory impedance of the respiratory system [P0.1/TV/inspiratory time (Ti)].


RESULTS
The continuous iv administration of 0.2 to 0.3 micro g x kg(-1) x hr(-1) of sufentanil resulted in the desired level of sedation. No significant heart rate, heart rhythm and blood pressure changes were observed. Sufentanil infusion did not affect TV, minute volume, Ti/inspiratory duty cycle, RR, P0.1, P0.1/TV/Ti and gas exchange did not change significantly over the study period.


CONCLUSIONS
A continuous infusion of sufentanil induces "awake" sedation with no detectable effects on respiratory variables in critically ill patients during partial ventilatory support.
Conti
Giorgio
G
Department of Anesthesia and Intensive Care, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Rome, Italy. g.conti@rm.unicatt.it
Arcangeli
Andrea
A
Antonelli
Massimo
M
Cavaliere
Franco
F
Costa
Roberta
R
Simeoni
Francesca
F
Proietti
Rodolfo
R
D000328:Adult; D000368:Aged; D000403:Airway Resistance / Q000187:drug effects; D018686:Anesthetics, Intravenous; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012131:Respiratory Insufficiency / Q000628:therapy; D015656:Respiratory Mechanics / Q000187:drug effects*; D017409:Sufentanil; D013990:Tidal Volume / Q000187:drug effects
D018686:Anesthetics, Intravenous; D017409:Sufentanil