INHALATION SEDATION IN SUBJECTS WHIT ARDS UNDERGOING CONTINUOUS LATERAL ROTATIONAL THERAPY
CONCLUSION
Subjects required less opioids and were able to breathe spontaneously while deeply sedate compared to sedation with propofol/midazolam. No adverse events were noted related to isoflurane sedation.
RESULTS
Subjects' medical histories prior to continuous lateral rotational therapy were not significantly different between groups.
During the observation period, a total of 38 subjects were treated with continuous lateral rotational therapy and sedation. All subjects were studied and followed for hospital stay: 19 in the intravenous and 19 in the isoflurane group.
DATA SOURCE AND MEASUREMENTS
Data were extracted from the ICU patient data management system. Vital parameters such as heart rate, invasive mean arterial pressure, blood gases, and ventilatory parameters wew automatically transferred to this system and stored after having been checked by the nurses for plausibility
GROUP PROTOCOLS
The treatment of all subjects depend on the disease process and not on the mode of sedation. Before that date, all patients received propofol or midazolam for sedation.
METHODS
QUICK LOOK
what this study adds to our knowledge
Current knowledge
The indication to use continuous lateral rotational therapy was severe oxygenation failure (PaO2/FiO2 <150 mm Hg) with contra-indications for prone positioning.
This retrospective case analysis was approved by the local ethics committee. From the hospital information system, all patients whith continuous lateral rotational therapy were identified retrospectively.
INTRODUCTION
The patients suffering from ARDS require invasive positive pressure ventilation as well as some kind of positioning therapy.
DISCUSSION
Nevertheless, our study was not powered to detect differences in mortality. Further multi-center, randomized, controlled trials are needed to investigate the possible benefits of sedation with isoflurane in patients with ARDS.
The strategy was feasible, with theoretical advantages including bronchodilation, cardiovascular and lung-protective effects, good control of the level of sedation.
