From the Departments of *Anesthesiology, Intensive Care Medicine and Pain Medicine, and †Internal Medicine V, Saarland University Medical Center, Homburg/Saar, Germany.
Anesth Analg. 2017 Oct;125(4):1235-1239. doi: 10.1213/ANE.0000000000001915.
Six patients suffering from acute respiratory distress syndrome with the need for extracorporeal membrane oxygenation (ECMO) therapy in deep sedation were included. Isoflurane sedation with the AnaConDa system was initiated within 24 hours after initiation of ECMO therapy and resulted in a satisfactory sedation (Richmond Agitation-Sedation Scale -4 to -5). Despite deep sedation, spontaneous breathing was possible in 6 of 6 patients. We observed a reduced need for vasopressor therapy and improved lung function (PaO2, PaCO2, delta P, and tidal volume) during isoflurane sedation. Opioid consumption could be reduced, and only very low doses of isoflurane were needed (1-3 mL/h). This small case series supports the feasibility of sedation using inhaled anesthetics concurrently with venovenous ECMO.
纳入了 6 名患有急性呼吸窘迫综合征并需要体外膜肺氧合 (ECMO) 治疗的深度镇静患者。在 ECMO 治疗开始后 24 小时内启动了异氟烷镇静，并使用 AnaConDa 系统进行镇静，结果令人满意（Richmond 躁动-镇静评分-4 至-5）。尽管深度镇静，但 6 名患者中有 6 名能够自主呼吸。我们观察到在异氟烷镇静期间，血管加压药治疗的需求减少，肺功能（PaO2、PaCO2、delta P 和潮气量）得到改善。阿片类药物的消耗减少，只需使用非常低剂量的异氟烷（1-3 毫升/小时）。这个小病例系列支持同时使用吸入麻醉剂和静脉-静脉 ECMO 进行镇静的可行性。
