title: Inhaled Sedation in Patients With Acute Respiratory Distress Syndrome Undergoing Extracorporeal Membrane Oxygenation.
abstract: Six patients suffering from acute respiratory distress syndrome with the need for extracorporeal membrane oxygenation (ECMO) therapy in deep sedation were included. Isoflurane sedation with the AnaConDa system was initiated within 24 hours after initiation of ECMO therapy and resulted in a satisfactory sedation (Richmond Agitation-Sedation Scale -4 to -5). Despite deep sedation, spontaneous breathing was possible in 6 of 6 patients. We observed a reduced need for vasopressor therapy and improved lung function (PaO2, PaCO2, delta P, and tidal volume) during isoflurane sedation. Opioid consumption could be reduced, and only very low doses of isoflurane were needed (1-3 mL/h). This small case series supports the feasibility of sedation using inhaled anesthetics concurrently with venovenous ECMO.
authors.affiliation: From the Departments of *Anesthesiology, Intensive Care Medicine and Pain Medicine, and †Internal Medicine V, Saarland University Medical Center, Homburg/Saar, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meiser
authors.forename: Hagen
authors.initials: H
authors.lastname: Bomberg
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Lepper
authors.forename: Franziska C
authors.initials: FC
authors.lastname: Trudzinski
authors.forename: Thomas
authors.initials: T
authors.lastname: Volk
authors.forename: Heinrich V
authors.initials: HV
authors.lastname: Groesdonk
mesh_terms: D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001784:Blood Gas Analysis / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007530:Isoflurane / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D013990:Tidal Volume / Q000187:drug effects / Q000502:physiology
chemical_list: D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D007530:Isoflurane