AnaConDa Device: Solution to Perform Cardiac Surgery Without Intravenous Anesthetic During the Corona Virus Disease 2019 Pandemic

Labaste, François; Rey, Valentin; Gonzalez, Hélène; Marcheix, Bertrand; Fourcade, Olivier; Minville, Vincent

doi:10.1053/j.jvca.2020.09.121

Cited by 2 publications

(6 citation statements)

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“…The COVID-19 pandemic prompted us to innovate, enabling our institution to sustain cardiac surgery activities, and we diversified the use of Sedaconda ( 13 ). Total inhaled anesthesia with sevoflurane is rarely employed in adults.…”

Section: Discussionmentioning

confidence: 99%

“…First, we did not standardize the administration of sevoflurane to achieve cardioprotection. In our unit, the adoption of inhaled anesthesia intra operatively and postoperatively, along with the use of Sedaconda, became necessary due to the shortage of intravenous anesthesia drugs during the COVID-19 pandemic ( 13 ). Specifically, we did not set MAC targets but only sedation goals, maintaining a BIS ® (Bispectral index) between 40 and 60.…”

Section: Discussionmentioning

confidence: 99%

“…The inhaled protocol was implemented during the COVID-19 pandemic. Our solution has been previously described and was based on the utilization of a small Sedaconda-ACD device, with a dead space of 50 ml (Anaesthetic Conserving Device, Sedana Medical, Uppsala, Sweden) ( 13 ). After anesthesia induction, Sedaconda-ACD was inserted in the breathing circuit between the endotracheal tube and the Y-piece.…”

Section: Methodsmentioning

confidence: 99%

“…We considered the idea of diverting the usual use of an anesthesia preservation device to enable us to provide anesthesia with total inhalation anesthesia with sevoflurane. We have previously described our solution to perform cardiac surgery without intravenous sedative anesthetic drugs by using an anesthetic conserving device (Sedaconda ACD-S, Sedana Medical, Uppsala, Sweden) ( 13 ). Sedaconda-ACD appears to be a practical and good device for providing total inhaled anesthesia with sevoflurane.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative outcomes after total sevoflurane inhalation sedation using a disposable delivery system (Sedaconda-ACD) in cardiac surgery

Labaste,

Cauquil,

Lestarquit

et al. 2024

Front. Med.

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IntroductionThe COVID-19 pandemic prompted our team to develop new solutions for performing cardiac surgery without intravenous anesthetics due to a shortage of these drugs. We utilized an anesthetic conserving device (Sedaconda-ACD) to administer total inhaled anesthesia because specific vaporizers were unavailable for administering inhaled agents during cardiopulmonary bypass (CPB) in our center. We documented our experience and postoperative cardiovascular outcomes. The primary outcome was the peak level of troponin, with secondary outcomes encompassing other cardiovascular complications.Material and methodsA single-center retrospective study was conducted. We performed a multivariate analysis with a propensity score. This investigation took place at a large university referral center.ParticipantsAdult patients (age ≥ 18) who underwent elective cardiac surgery with CPB between June 2020 to March 2021.InterventionDuring the inclusion period, two anesthesia protocols for the maintenance of anesthesia coexisted—total inhaled anesthesia with Sedaconda-ACD and our classic protocol with intravenous drugs during and after CPB.Primary endpointTroponin peak level recorded after surgery (highest level recorded within 48 h following the surgery).ResultsOut of the 654 included patients, 454 were analyzed after matching (intravenous group = 297 and inhaled group = 157). No significant difference was found between the groups in postoperative troponin peak levels (723 ng/l vs. 993 ng/l–p = 0.2). Total inhaled anesthesia was associated with a decreased requirement for inotropic medications (OR = 0.53, 95% CI 0.29–0.99, p = 0.04).ConclusionIn our cohort, the Sedaconda-ACD device enabled us to achieve anesthesia without intravenous agents, and we did not observe any increase in postoperative complications. Total inhaled anesthesia with sevoflurane was not associated with a lower incidence of myocardial injury assessed by the postoperative troponin peak level. However, in our cohort, the use of inotropic drugs was lower.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postoperative outcomes after total sevoflurane inhalation sedation using a disposable delivery system (Sedaconda-ACD) in cardiac surgery

Labaste,

Cauquil,

Lestarquit

et al. 2024

Front. Med.

Self Cite

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“…We read with interest the letter to the editor from Labaste et al 1 We welcome the initiative of the authors to look for an alternative to intravenous drugs to sedate patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with volatile anesthetics (VA), using the Anesthetic Conserving Device (AnaConDa) (Sedana Medical, Uppsala, Sweden), in times of drug shortages. AnaConDa initially was created for inhaled sedation of patients ventilated with intensive care ventilators.…”

mentioning

confidence: 99%

In Reply to “Letter to the Editor: AnaConDa Device: Solution to Perform Cardiac Surgery Without Intravenous Anesthetic During the Coronavirus Disease 2019 Pandemic”

Kermad

Volk

Meiser

2020

Journal of Cardiothoracic and Vascular Anesthesia

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AnaConDa Device: Solution to Perform Cardiac Surgery Without Intravenous Anesthetic During the Corona Virus Disease 2019 Pandemic

Cited by 2 publications

References 3 publications

Postoperative outcomes after total sevoflurane inhalation sedation using a disposable delivery system (Sedaconda-ACD) in cardiac surgery

Postoperative outcomes after total sevoflurane inhalation sedation using a disposable delivery system (Sedaconda-ACD) in cardiac surgery

In Reply to “Letter to the Editor: AnaConDa Device: Solution to Perform Cardiac Surgery Without Intravenous Anesthetic During the Coronavirus Disease 2019 Pandemic”

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