Volatile Anesthetic Sedation During Therapeutic Hypothermia After Cardiac Arrest in the ICU

Berger, Miles; Warner, David S.; McDonagh, David L.

doi:10.1097/01.ccm.0000435689.93091.d0

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…With knowledge from the available data, a benefit in mortality will be reached with a caloric target of around 80% of measured energy expenditure, and a protein load of at least 1,25 mg/kg/day [31]. The optimal way to reach caloric targets is the use of supplemental parenteral nutrition, as enteral nutrition proves to be largely inefficient [32]. As such, the potential benefit of an optimal nutritional therapy needs to be accompanied by an optimal glycemic treatment.…”

Section: Discussionmentioning

confidence: 99%

Inadequate glycemic control in patients receiving parenteral nutrition lowers survival: A retrospective observational trial

Coudenys

Waele

Meers

et al. 2018

Clinical Nutrition Experimental

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Background & aims: Parenteral Nutrition (PN) has been shown to cause glycemic deregulation, whether patients have type 2 diabetes (T2DM) or not, causing elevated mortality, despite intensive insulin treatment. Long-term effects, however, are unclear. Methods: A retrospective observational study was performed. 226 patients of the UZ Brussel, both T2DM patients and non-diabetics, who received PN in 2013 or 2014, were analyzed on the presence of hyperglycemia and hypoglycemia, as well as mortality inhospital and after 6 months. Results: Here we show that T2DM patients displaying either hyperor hypoglycemia, had a significant higher mortality. This was the case both in-hospital and after 6 months. Non-diabetics undergoing hyperglycemia had a similar fate, but not when these patients had hypoglycemic events. Conclusion: Whether PN-receiving patients had T2DM or were non-diabetic, hyperglycemia was related to mortality, both in-List of abbreviations: PN, parenteral nutrition; T2DM, type 2 diabetes; T1DM, type 1 diabetes.

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Section: Discussionmentioning

confidence: 99%

Inadequate glycemic control in patients receiving parenteral nutrition lowers survival: A retrospective observational trial

Coudenys

Waele

Meers

et al. 2018

Clinical Nutrition Experimental

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“…8,[35][36][37] This whole process also requires the use of medications for sedation and paralysis, which introduces another dimension of complexity, both in management and neuroprognostication, as will be discussed shortly. 38 In current practice, multidisciplinary teams consisting of intensive care specialists, neurologists, cardiologists, pulmonologists, nephrologists, hepatologists, and multiple other subspecialists closely manage patients after cardiac arrest. Every effort is made to quickly cool patients to a target temperature of 32-36 °C based on institutionspecific protocols.…”

Section: Minimizing Neurologic Injury Postarrestmentioning

confidence: 99%

The critically ill brain after cardiac arrest

Medicherla

Lewis

2020

Annals of the New York Academy of Sciences

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Cardiac arrest can cause hypoxic-anoxic ischemic brain injury due to signaling cascades that lead to damaged cell membranes and vital cellular organelles, resulting in cell death in the setting of low or no oxygen. Some brain areas are more prone to damage than others, so patients with hypoxic-anoxic ischemic brain injury present with several outcomes, including reduced level of consciousness or alertness, memory deficits, uncoordinated movements, and seizures. Some patients may have mild deficits, while others may have such severe injury that it can progress to brain death. High-quality cardiopulmonary resuscitation is a proven technique to improve outcome after cardiac arrest, although morbidity and mortality remain high. Induced hypothermia, which involves artificially cooling the body immediately after cardiac arrest, may reduce injury to the brain and improve morbidity and mortality. Neuroprognostication after cardiac arrest is challenging and requires a multimodal approach involving clinical neurologic examinations, brain imaging, electrical studies to assess brain activity, and biomarkers to predict outcome.

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“…Volatile anaesthetics, such as sevoflurane and isoflurane, have been proposed as alternative sedatives in this population, due to their rapid offset, which may allow earlier opportunities for neurological assessment. (7,8). Other purported benefits of these agents include decreased cerebral metabolic rate.…”

Section: Introductionmentioning

confidence: 99%

Inhaled anaesthesia compared with conventional sedation in post cardiac arrest patients undergoing temperature control: A systematic review and meta-analysis

et al. 2022

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Volatile Anesthetic Sedation During Therapeutic Hypothermia After Cardiac Arrest in the ICU

Cited by 4 publications

References 16 publications

Inadequate glycemic control in patients receiving parenteral nutrition lowers survival: A retrospective observational trial

Inadequate glycemic control in patients receiving parenteral nutrition lowers survival: A retrospective observational trial

The critically ill brain after cardiac arrest

Inhaled anaesthesia compared with conventional sedation in post cardiac arrest patients undergoing temperature control: A systematic review and meta-analysis

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