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Titel: Volatile anesthetics for lung- and diaphragm-protective sedation
VerfasserIn: Müller-Wirtz, Lukas M.
O'Gara, Brian
Gama de Abreu, Marcelo
Schultz, Marcus J.
Beitler, Jeremy R.
Jerath, Angela
Meiser, Andreas
Sprache: Englisch
Titel: Critical Care
Bandnummer: 28
Heft: 1
Verlag/Plattform: BMC
Erscheinungsjahr: 2024
Freie Schlagwörter: Intensive care
Inhaled sedation
Volatile anesthetics
Ventilation
Lung
Diaphragm
Ventilator weaning
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: This review explores the complex interactions between sedation and invasive ventilation and examines the potential of volatile anesthetics for lung- and diaphragm-protective sedation. In the early stages of invasive ventilation, many critically ill patients experience insufficient respiratory drive and effort, leading to compromised diaphragm function. Compared with common intravenous agents, inhaled sedation with volatile anesthetics better preserves respiratory drive, potentially helping to maintain diaphragm function during prolonged periods of invasive ventilation. In turn, higher concentrations of volatile anesthetics reduce the size of spontaneously generated tidal volumes, potentially reducing lung stress and strain and with that the risk of self-inflicted lung injury. Taken together, inhaled sedation may allow titration of respiratory drive to maintain inspiratory efforts within lung- and diaphragm-protective ranges. Particularly in patients who are expected to require prolonged invasive ventilation, in whom the restoration of adequate but safe inspiratory effort is crucial for successful weaning, inhaled sedation represents an attractive option for lung- and diaphragm-protective sedation. A technical limitation is ventilatory dead space introduced by volatile anesthetic reflectors, although this impact is minimal and comparable to ventilation with heat and moisture exchangers. Further studies are imperative for a comprehensive understanding of the specific effects of inhaled sedation on respiratory drive and effort and, ultimately, how this translates into patient-centered outcomes in critically ill patients.
DOI der Erstveröffentlichung: 10.1186/s13054-024-05049-0
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-432219
hdl:20.500.11880/38777
http://dx.doi.org/10.22028/D291-43221
ISSN: 1364-8535
Datum des Eintrags: 22-Okt-2024
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Anästhesiologie
Professur: M - Prof. Dr. Thomas Volk
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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