Please use this identifier to cite or link to this item:
doi:10.22028/D291-42179
Title: | Neuropsychological follow-up of isoflurane sedated intensive care patients: a substudy of a randomized trial |
Author(s): | Fuchs, Verena F. Simon, Henrik V. Soldinger, Nina Volk, Thomas Meiser, Andreas |
Language: | English |
Title: | Minerva Anestesiologica |
Volume: | 90 |
Issue: | 5 |
Pages: | 377-385 |
Publisher/Platform: | Edizioni Minerva Medica |
Year of Publication: | 2024 |
Free key words: | Critical care Isoflurane Propofol Delirium |
DDC notations: | 610 Medicine and health |
Publikation type: | Journal Article |
Abstract: | BACKGROUND: Inhaled sedation of intensive care unit (ICU) patients ventilated >24 hours may have long term effects. We hypothesized that isoflurane has a better neuropsychological outcome in a one-year follow-up compared to propofol sedation. METHODS: All 66 patients included by the coordinating center of the ISOCONDA study (EudraCT#: 2016-004551-67) took part in this substudy (DRKS00020240). A delirium test (CAM-ICU) was performed 24 hours after end of sedation. Sedation-, ventilator-, ICU- and delirium-free days within 30 days were calculated. Patients were sent five questionnaires one, three and twelve months after ICU discharge: ICU-Memory-tool (ICU-MT), Short-Form-36-Health-survey (SF-36), PosttraumaticStress-Scale-14 (PTSS-14), WHO-Five-Well-Being-Index (WHO-5) and Hospital-Anxiety-Depression-Scale (HADS). RESULTS: CAM-ICU was positive in 17% of patients, however 68% showed signs of delirium during the ICU stay (no group differences). Mortality was lower after isoflurane (30-days: 1/33 versus 7/33, P=0.024; One-year: 9/33 versus 14/33, P=0.156). Isoflurane led to significantly more sedation- (median [IQR]: 28[25-29] versus 24[21-29], P=0.016), ventilator- (28[24-29] versus 22[4-28], P=0.011), ICU- (23[13-26] versus 11[0-25], P=0.044) and delirium-free days (25[21-29] versus 20[12-28], P=0.031). Return rate of questionnaires was high (87/128). In the ICU-MT, isoflurane patients recalled significantly more factual memories after one year. Generally, the psychological tests suggested a poor quality of life (SF36), high rates of post-traumatic-stress-disorder (PTSS-14: 38%) and depression (WHO-5: 54%, HADS: 43%), without significant group differences. CONCLUSIONS: Isoflurane sedation leads to more delirium free days during the ICU treatment and more factual memories of the ICU stay one year after the ICU stay. However long-term outcome of ventilated ICU patients is poor, and there were no differences between isoflurane and propofol sedation. (Cite this article as: Fuchs VF, Simon HV, Soldinger N, Volk T, Meiser A. Neuropsychological follow-up of isoflurane sedated intensive care patients: a substudy of a randomized trial. Minerva Anestesiol 2024;90:377-85. DOI: 10.23736/S0375- 9393.24.17834-0) |
DOI of the first publication: | 10.23736/S0375-9393.24.17834-0 |
URL of the first publication: | https://www.minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2024N05A0377 |
Link to this record: | urn:nbn:de:bsz:291--ds-421793 hdl:20.500.11880/37865 http://dx.doi.org/10.22028/D291-42179 |
ISSN: | 1827-1596 0375-9393 |
Date of registration: | 13-Jun-2024 |
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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