Please use this identifier to cite or link to this item: doi:10.22028/D291-39760
Title: Ventilatory Effects of Isoflurane Sedation via the Sedaconda ACD-S versus ACD-L : A Substudy of a Randomized Trial
Author(s): Müller-Wirtz, Lukas M.
Becher, Tobias
Günther, Ulf
Bellgardt, Martin
Sackey, Peter
Volk, Thomas
Meiser, Andreas
Language: English
Title: Journal of Clinical Medicine
Volume: 12
Issue: 9
Publisher/Platform: MDPI
Year of Publication: 2023
Free key words: anesthesia
critical care
intensive care
volatile anesthetic
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Devices used to deliver inhaled sedation increase dead space ventilation. We therefore compared ventilatory effects among isoflurane sedation via the Sedaconda ACD-S (internal volume: 50 mL), isoflurane sedation via the Sedaconda ACD-L (100 mL), and propofol sedation with standard mechanical ventilation with heat and moisture exchangers (HME). This is a substudy of a randomized trial that compared inhaled isoflurane sedation via the ACD-S or ACD-L to intravenous propofol sedation in 301 intensive care patients. Data from the first 24 h after study inclusion were analyzed using linear mixed models. Primary outcome was minute ventilation. Secondary outcomes were tidal volume, respiratory rate, arterial carbon dioxide pressure, and isoflurane consumption. In total, 151 patients were randomized to propofol and 150 to isoflurane sedation; 64 patients received isoflurane via the ACD-S and 86 patients via the ACD-L. While use of the ACD-L was associated with higher minute ventilation (average difference (95% confidence interval): 1.3 (0.7, 1.8) L/min, p < 0.001), higher tidal volumes (44 (16, 72) mL, p = 0.002), higher respiratory rates (1.2 (0.1, 2.2) breaths/min, p = 0.025), and higher arterial carbon dioxide pressures (3.4 (1.2, 5.6) mmHg, p = 0.002), use of the ACD-S did not significantly affect ventilation compared to standard mechanical ventilation and sedation. Isoflurane consumption was slightly less with the ACD-L compared to the ACD-S (−0.7 (−1.3, 0.1) mL/h, p = 0.022). The Sedaconda ACD-S compared to the ACD-L is associated with reduced minute ventilation and does not significantly affect ventilation compared to a standard mechanical ventilation and sedation setting. The smaller ACD-S is therefore the device of choice to minimize impact on ventilation, especially in patients with a limited ability to compensate (e.g., COPD patients). Volatile anesthetic consumption is slightly higher with the ACD-S compared to the ACD-L.
DOI of the first publication: 10.3390/jcm12093314
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-397604
ISSN: 2077-0383
Date of registration: 16-May-2023
Description of the related object: Supplementary Materials
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Anästhesiologie
Professorship: M - Prof. Dr. Thomas Volk
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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