Schwere Exazerbation einer beatmungspflichtigen COPD

Laufenberg, M.; Schneider, Thomas-Michael

doi:10.1007/s00063-016-0199-z

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…In our case, the anesthetic conservation device enabled the administration of isoflurane via a regular ICU ventilator (Hamilton G5, Hamilton Medical). This proved a safe and convenient method, as described in previous studies 23–25 . The temporal correlation between the onset of isoflurane application and the increase in tidal volumes observed in our patient (Figure 3) makes it tempting to assume causality.…”

Section: Discussionsupporting

confidence: 66%

“…This proved a safe and convenient method, as described in previous studies. [23][24][25] The temporal correlation between the onset of isoflurane application and the increase in tidal volumes observed in our patient (Figure 3) makes it tempting to assume causality. Of note, this effect occurred minimal initial tidal volumes, calling an effective delivery of isoflurane to the deeper airways into question.…”

Section: Discussionmentioning

confidence: 90%

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VV‐ECMO as bridge and safety net for successful therapeutic polypragmasy in a case of influenza‐triggered near‐fatal asthma

Kowalewski,

Schnürer,

Kopp

et al. 2023

Clinical Case Reports

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Key Clinical MessageIn near‐fatal asthma, the combination of ECMO therapy and isoflurane application via an intensive care ventilator with an anesthetic conservation device represents a therapeutic combination in seemingly hopeless clinical situations.AbstractWe report a case of an adult patient with near‐fatal asthma, who was implanted venovenous extracorporeal membrane oxygenation in an extern hospital before transfer to our tertiary center. After 13 days and various therapeutic approaches, including inhaled isoflurane therapy via an anesthetic‐conserving device, the patient was decannulated and extubated 3 days later.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 90%

VV‐ECMO as bridge and safety net for successful therapeutic polypragmasy in a case of influenza‐triggered near‐fatal asthma

Kowalewski,

Schnürer,

Kopp

et al. 2023

Clinical Case Reports

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Inhalative sedation with small tidal volumes under venovenous ECMO

et al. 2018

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Volatile Sedation for Acute Respiratory Distress Syndrome Patients on Venovenous Extracorporeal Membrane Oxygenation and Ultraprotective Ventilation

Grasselli

Giani

Scaravilli

et al. 2021

Critical Care Explorations

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Objectives: Patients on extracorporeal support for severe acute respiratory distress syndrome may require a prolonged period of deep sedation. In these patients, volatile sedation may represent a valid alternative to IV drugs. The aim of our study was to describe the feasibility of volatile sedation in a large cohort of acute respiratory distress syndrome patients undergoing venovenous extracorporeal membrane oxygenation and ultraprotective ventilation. Design: Retrospective monocentric study. Setting: Adult ICU, ASST Monza, Italy. Patients: Adult patients who underwent volatile sedation with isoflurane during venovenous extracorporeal membrane oxygenation between 2009 and 2019. Interventions: Isoflurane was delivered via the AnaConDa system. The sedation level, hemodynamics, and laboratory tests were compared between the volatile sedation phase and the IV sedation phases before and after the isoflurane sedation period. Measurements and Main Results: About 74 patients (50 yr [43–56 yr]) were included. Median duration of venovenous extracorporeal membrane oxygenation support was 22 days (14–51 d). Volatile sedation started on day 3 (2–6) of extracorporeal membrane oxygenation support, and its median duration was 7 days (4–13 d), ranging from 1 to 38 days. A total of 970 venovenous extracorporeal membrane oxygenation days were analyzed. During the volatile phase, the sedation level was slightly deeper (bispectral index 39 ± 6) compared with the IV phase before and after isoflurane (42 ± 8 and 43 ± 9, respectively, p < 0.001). Requirements of fentanyl and remifentanyl were reduced during the volatile phase. Minor differences in hemodynamics were observed during volatile sedation: mean arterial pressure was lower (75 ± 13 vs 79 ± 14 and 80 ± 15; p < 0.001), whereas cardiac output was higher (8.5 ± 1.9 vs 7.9 ± 1.8 and 8.0 ± 1.8; p = 0.003). Aspartate aminotransferase levels were lower during the volatile sedation phases (p < 0.001), whereas alanine aminotransferase, triglycerides, and creatine phosphokinase were more altered during the IV sedation phase before isoflurane (p < 0.001). Conclusions: Volatile sedation represents an alternative to IV agents to achieve long-term deep sedation in critically ill patients on extracorporeal membrane oxygenation undergoing ultraprotective ventilation.

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Schwere Exazerbation einer beatmungspflichtigen COPD

Cited by 3 publications

References 11 publications

VV‐ECMO as bridge and safety net for successful therapeutic polypragmasy in a case of influenza‐triggered near‐fatal asthma

VV‐ECMO as bridge and safety net for successful therapeutic polypragmasy in a case of influenza‐triggered near‐fatal asthma

Inhalative sedation with small tidal volumes under venovenous ECMO

Volatile Sedation for Acute Respiratory Distress Syndrome Patients on Venovenous Extracorporeal Membrane Oxygenation and Ultraprotective Ventilation

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