七氟醚与丙泊酚用于新型冠状病毒肺炎急性呼吸窘迫综合征患者镇静的随机临床试验结果
Sedation with Sevoflurane versus Propofol in COVID-19 Patients with Acute Respiratory Distress Syndrome: Results from a Randomized Clinical Trial.
作者信息
Martínez-Castro Sara, Monleón Berta, Puig Jaume, Ferrer Gomez Carolina, Quesada Marta, Pestaña David, Balvis Alberto, Maseda Emilio, de la Rica Alejandro Suárez, Feijoo Ana Monero, Badenes Rafael
机构信息
Department Anesthesiology, Surgical-Trauma Intensive Care and Pain Clinic, Hospital Clínic Universitari, University of Valencia, 46010 Valencia, Spain.
Anesthesiology and Intensive Care Department, Consorcio Hospital General Universitario, 46014 Valencia, Spain.
出版信息
J Pers Med. 2023 May 31;13(6):925. doi: 10.3390/jpm13060925.
BACKGROUND
Acute respiratory distress syndrome (ARDS) related to COVID-19 (coronavirus disease 2019) led to intensive care units (ICUs) collapse. Amalgams of sedative agents (including volatile anesthetics) were used due to the clinical shortage of intravenous drugs (mainly propofol and midazolam).
METHODS
A multicenter, randomized 1:1, controlled clinical trial was designed to compare sedation using propofol and sevoflurane in patients with ARDS associated with COVID-19 infection in terms of oxygenation and mortality.
RESULTS
Data from a total of 17 patients (10 in the propofol arm and 7 in the sevoflurane arm) showed a trend toward PaO/FiO improvement and the sevoflurane arm's superiority in decreasing the likelihood of death (no statistical significance was found).
CONCLUSIONS
Intravenous agents are the most-used sedative agents in Spain, even though volatile anesthetics, such as sevoflurane and isoflurane, have shown beneficial effects in many clinical conditions. Growing evidence demonstrates the safety and potential benefits of using volatile anesthetics in critical situations.
背景
与2019冠状病毒病（COVID-19）相关的急性呼吸窘迫综合征（ARDS）导致重症监护病房（ICU）不堪重负。由于静脉药物（主要是丙泊酚和咪达唑仑）临床短缺，使用了镇静剂（包括挥发性麻醉剂）的混合物。
方法
设计了一项多中心、1:1随机对照临床试验，比较丙泊酚和七氟醚用于COVID-19感染相关ARDS患者镇静时在氧合和死亡率方面的差异。
结果
共17例患者的数据（丙泊酚组10例，七氟醚组7例）显示，氧合指数（PaO₂/FiO₂）有改善趋势，且七氟醚组在降低死亡可能性方面更具优势（未发现统计学意义）。
结论
在西班牙，静脉药物是最常用的镇静剂，尽管挥发性麻醉剂如七氟醚和异氟醚在许多临床情况下已显示出有益效果。越来越多的证据表明，在危急情况下使用挥发性麻醉剂具有安全性和潜在益处。
Zotero 插件