Prolonged Sevoflurane Inhalation Was Not Nephrotoxic in Two Patients with Refractory Status Asthmaticus

Mori, Naohisa; Nagata, Hirofumi; Ohta, Sukejuro; Suzuki, Masahiro

doi:10.1213/00000539-199607000-00035

Cited by 15 publications

(5 citation statements)

References 15 publications

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“…Sevoflurane has a relatively high rate of metabolic degradation and is also known to produce metabolites which are potentially nephrotoxic [5,6]. Nevertheless, its prolonged use is found to be safe in various case reports, including infants and pregnant women [8][9][10][11][12]. Sevoflurane has been shown to be quite useful in cases of difficult intubations like epiglottis [13].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Severe Asthma Exacerbation with Sevoflurane Inhalation in the Intensive Care Unit

Sorour

Vyas

Raval

et al. 2015

JACCOA

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Severe Asthma Exacerbation with Sevoflurane Inhalation in the Intensive Care Unit

Sorour

Vyas

Raval

et al. 2015

JACCOA

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“…Several clinical reports have shown the clinical usefulness of sevoflurane at anesthetic (2-3%) or subanesthetic « 1%) doses.in managing severe respiratory failure associated with airway obstruction. In two adult patients ventilated for status asthmaticus, Mori et al reported that inhaled sevoflurane (1 to 4%) decreased peak airway pressures using the same tidal volumes (7). Similarly, Schultz described a 26-yearold woman in whom status asthmaticus responded to positive pressure ventilation and sevoflurane inhalation (8%) after conventional therapy had failed (salbutamol, epinephrine and methylprednisolone) (8).…”

Section: Discussionmentioning

confidence: 99%

“…Neither of two young patients we report had clinical symptoms or laboratory data indicating hepatic or renal dysfunction during prolonged sevoflurane inhalation. Although long-term use of sevoflurane might cause organ dysfunction, such as renal tubular injury, hepatotoxicity and neuropathy (14), accumulating evidence suggests that prolonged sevoflurane inhalation is safe in adults and infants (7)(8)(9)(10)(11).…”

Section: Discussionmentioning

confidence: 99%

Sevoflurane Inhalation for Severe Bronchial Obstruction in Infants with Bronchiolitis

Papoff

Caresta

Gazzanelli

et al. 2012

Int J Immunopathol Pharmacol

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Bronchiolitis is a lower respiratory tract viral infection which may result in severe bronchial obstruction and respiratory failure despite treatment with beta-adrenergic agonists and glucocorticoids. Here we describe two otherwise healthy infants with severe bronchiolitis whose clinical course was complicated by marked bronchial obstruction and respiratory acidosis refractory to conventional medications (β-stimulants, anticholinergics and corticosteroids) and non-invasive positive pressure ventilation. Sevoflurane inhalation allowed both infants to attain a sustained, clinical improvement in ventilation and one patient to avoid mechanical ventilation. We suggest that sevoflurane inhalation may be a therapeutic option in the treatment of young infants with severe bronchiolitis who respond poorly to conventional therapy.

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“…Increased serum inorganic fluoride level above the accepted toxic threshold (> 50 mmol/L) was detected with the peak of 61.1 mmol/L at 4 h after discontinuation of sevoflurane. However, serum creatinine and BUN were unchanged [108]. Watanabe et al reported a case report of 3-month old with mild laryngomalacia who experienced severe bronchospasm resistant to conventional therapies and required intubation.…”

Section: Refractory Status Asthmaticusmentioning

confidence: 99%

Toxicity of inhaled agents after prolonged administration

Manatpon

Kofke

2017

J Clin Monit Comput

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Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age. This review overviews potential for and potential mechanisms of neurotoxicity and systemic toxicity of prolonged inhaled anesthesia and clinical scenarios where inhaled anesthesia has been used in order to assess safety of possible prolonged use for sedation. High dose inhaled agents are associated with postoperative cognitive dysfunction (POCD) and other situations. However, thus far no strong indication of problematic neuro or organ toxicity has been demonstrated after prolonged use of low dose volatile anesthesia.

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Prolonged Sevoflurane Inhalation Was Not Nephrotoxic in Two Patients with Refractory Status Asthmaticus

Cited by 15 publications

References 15 publications

Successful Treatment of Severe Asthma Exacerbation with Sevoflurane Inhalation in the Intensive Care Unit

Successful Treatment of Severe Asthma Exacerbation with Sevoflurane Inhalation in the Intensive Care Unit

Sevoflurane Inhalation for Severe Bronchial Obstruction in Infants with Bronchiolitis

Toxicity of inhaled agents after prolonged administration

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