ArticleAnnals of intensive care2019
Does volatile sedation with sevoflurane allow spontaneous breathing during prolonged prone positioning in intubated ARDS patients? A retrospective observational feasibility trial.
Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- Volatile anesthetic sedation in acute respiratory distress syndrome.Intensive care medicine · 2026Review
- Kinetics of Sevoflurane Vaporized Directly in Extracorporeal Membrane Oxygenators-Ex Vivo Findings and Pharmacokinetic/Pharmacodynamic Simulations.European journal of drug metabolism and pharmacokinetics · 2026Article
- Lung protective characteristics of volatile anesthetic sedation.Critical care (London, England) · 2026Review
- Prolonged in vitro anti-bacterial, anti-inflammatory, and surfactant-promoting effects of volatile anesthetics.BMC pulmonary medicine · 2025Article
- Sedation management and processed EEG-based solutions during venovenous extracorporeal membrane oxygenation: a narrative review of key challenges and potential benefits.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- Volatile anesthetics for lung- and diaphragm-protective sedation.Critical care (London, England) · 2024Review
- Improved understanding of the respiratory drive pathophysiology could lead to earlier spontaneous breathing in severe acute respiratory distress syndrome.European journal of anaesthesiology and intensive care · 2023Article
- Ventilatory Effects of Isoflurane Sedation via the Sedaconda ACD-S versus ACD-L: A Substudy of a Randomized Trial.Journal of clinical medicine · 2023Article
- Article
- Increased Respiratory Drive after Prolonged Isoflurane Sedation: A Retrospective Cohort Study.Journal of clinical medicine · 2022Article
- Sevoflurane in combination with esketamine is an effective sedation regimen in COVID-19 patients enabling assisted spontaneous breathing even during prone positioning.Anaesthesiology intensive therapy · 2022Article
- Comparison of isoflurane and propofol sedation in critically ill COVID-19 patients-a retrospective chart review.Journal of anesthesia · 2021Article
- Analgesia and sedation in patients with ARDS.Intensive care medicine · 2020Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLung-protective ventilation and prolonged prone positioning (PP) are presented as essential in treating acute respiratory distress syndrome (ARDS). The optimal respirator mode, however, remains controversial. Pressure-supported spontaneous breathing (PS) during ARDS provides several advantages, but is difficult to achieve during PP because of respiratory depression as a side effect of sedative drugs. This study was designed to evaluate the feasibility and safety of PS during PP in ARDS patients sedated with inhaled sevoflurane.
resultsOverall, we have observed 4339 h of prone positioning in 62 patients who had a median of four prone episodes during treatment. Within 3948 h (91%), patients were successfully brought into a pressure-supported spontaneous breathing mode. The median duration of each prone episode was 17 h (IQR 3). Median duration of pressure-supported spontaneous breathing per episode was 16 h (IQR 5). Just one self-extubation occurred during 276 episodes of PP. CONCLUSIONS AND IMPLICATIONS: Pressure-supported spontaneous breathing during prolonged prone positioning in intubated ARDS patients with or without ECMO can be achieved during volatile sedation with sevoflurane. This finding may provide a basis upon which to question the latest dogma in ARDS treatment. Our concept must be further investigated and compared to controlled ventilation with regard to driving pressure, lung-protective parameters, muscle weakness and mortality before it can be routinely applied.
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