Efficacy of a simple scavenging system for long-term critical care sedation using volatile agent-based anesthesia

Wong, Kelvin K. L.; Wąsowicz, Marcin; Grewal, Deep; Fowler, Tara; Ng, Marianne; Ferguson, Niall D.; Steel, Andrew; Jerath, Angela

doi:10.1007/s12630-015-0562-1

Cited by 21 publications

(11 citation statements)

References 4 publications

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“…Routine monitoring as recommended by ASA (American Society of Anesthesiology) guidelines is required, with the addition of the monitoring of endtidal Minimal Alveolar Concentration (MAC). An end-tidal MAC of 0.2-0.5 typically achieves most sedation goals, with some variations seen in elderly and people with multiple comorbidities and encephalopathy [165]. The provision of volatile agents comes with the price of extra care for maintenance; this includes some daily device changes to preserve humidity and antimicrobial functions, taking extra caution during disconnection of circuits to prevent aerosolization of SARS-CoV-2 with vapor droplets, and the regular checking of scavenging systems to keep occupational levels of volatile agents acceptable.…”

Section: Practical Obstacles and Physiological Barriers Of Inhalation...mentioning

confidence: 99%

Sedating Mechanically Ventilated COVID-19 Patients with Volatile Anesthetics: Insights on the Last-Minute Potential Weapons

et al. 2021

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Coronavirus Disease 2019 (COVID-19) has spread globally with the number of cases exceeding seventy million. Although trials on potential treatments of COVID-19 Acute Respiratory Distress Syndrome (ARDS) are promising, the introduction of an effective therapeutic intervention seems elusive. In this review, we explored the potential therapeutic role of volatile anesthetics during mechanical ventilation in the late stages of the disease. COVID-19 is thought to hit the human body via five major mechanisms: direct viral damage, immune overactivation, capillary thrombosis, loss of alveolar capillary membrane integrity, and decreased tissue oxygenation. The overproduction of pro-inflammatory cytokines will eventually lead to the accumulation of inflammatory cells in the lungs, which will lead to ARDS requiring mechanical ventilation. Respiratory failure resulting from ARDS is thought to be the most common cause of death in COVID-19. The literature suggests that these effects could be directly countered by using volatile anesthetics for sedation. These agents possess multiple properties that affect viral replication, immunity, and coagulation. They also have proven benefits at the molecular, cellular, and tissue levels. Based on the comprehensive understanding of the literature, short-term sedation with volatile anesthetics may be beneficial in severe stages of COVID-19 ARDS and trials to study their effects should be encouraged.

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Section: Practical Obstacles and Physiological Barriers Of Inhalation...mentioning

confidence: 99%

Sedating Mechanically Ventilated COVID-19 Patients with Volatile Anesthetics: Insights on the Last-Minute Potential Weapons

et al. 2021

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“…Air pollution was first described by Sackey and colleagues in 2004, who reported mean ISO concentrations of approximately 0.1 ppm in patient rooms and peaks of up to 11 ppm during replacement of the AnaConDa™ filter . Subsequent studies found that waste VA concentrations were slightly higher (0.3‐2.0 ppm) in patient rooms and personnel's breathing zones, whereas the highest peaks (20‐50 ppm) were detected close to the expiratory port of the ventilator …”

Section: Discussionmentioning

confidence: 98%

Environmental safety: Air pollution while using MIRUS™ for short‐term sedation in the ICU

Herzog-Niescery

Vogelsang

Gude

et al. 2018

Acta Anaesthesiol Scand

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“…Recent studies have indicated that the currently available scavenger devices that are based on a silica zeolite matrix, adequately adsorb the volatile agents and thereby minimize environmental pollution by volatile anesthetic agents guaranteeing workplace safety[ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Exertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation

Heytens¹,

Bleecker²,

Verbrugghe³

et al. 2017

WJCCM

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In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units (ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique. As illustrated by the three case studies we elaborate upon, a thorough diagnostic work-up is needed to clarify the subsequent risk of strenuous exercise, and the anesthetic exposure to volatile agents in these patients and their families. Other contraindications for the use of volatile intensive care sedation consist of known malignant hyperthermia susceptibility, congenital myopathies, Duchenne muscular dystrophy, and intracranial hypertension.

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Efficacy of a simple scavenging system for long-term critical care sedation using volatile agent-based anesthesia

Cited by 21 publications

References 4 publications

Sedating Mechanically Ventilated COVID-19 Patients with Volatile Anesthetics: Insights on the Last-Minute Potential Weapons

Sedating Mechanically Ventilated COVID-19 Patients with Volatile Anesthetics: Insights on the Last-Minute Potential Weapons

Environmental safety: Air pollution while using MIRUS™ for short‐term sedation in the ICU

Exertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation

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