Evidence map›Paper›PMID 36042768›Full record

ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2022

Safety and Feasibility of AnaConDa™ to Deliver Inhaled Isoflurane for Sedation in Patients Undergoing Elective Postoperative Mechanical Ventilation: A Prospective, Open-label, Interventional Trial (INSTINCT I Study).

Atul Prabhakar Kulkarni, Shilpushp Jagannath Bhosale, Kushal Rajeev Kalvit, Tarun Kumar Sahu, Rakesh Mohanty, Meshach M Dhas, Gautam Gondal, Swapna Charie, Anjana Shrivastava, Jigeeshu V Divatia and 1 more

Open access · greenAbstract read
In one paragraph

Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Reckoning the Inhaled Sedation in Critically Ill Patients (INSTINCT) Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
    Article
  3. Inhaled Anesthetics for Sedation in ICU: Widening Horizons!Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Atul Prabhakar KulkarniDivision of Critical Care Medicine, Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0002-5172-7619
Shilpushp Jagannath BhosaleDivision of Critical Care Medicine, Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0002-0290-0526
Kushal Rajeev KalvitDepartment of Anesthesiology, Critical Care Medicine and Pain, Tata Memorial Hospital, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0002-2166-4557
Tarun Kumar SahuDepartment of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0003-0911-6862
Rakesh MohantyDivision of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0002-1804-3135
Meshach M DhasDivision of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0003-2709-7511
Gautam GondalDivision of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0001-5959-1632
Swapna CharieDivision of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0002-0578-4081
Anjana ShrivastavaDepartment of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0002-5984-1790
Jigeeshu V DivatiaDepartment of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.ORCID https://orcid.org/0000-0001-7384-4886
INhaled SedaTion IN CriTically ill patients – (INSTINCT) study
Tata Memorial Hospital · INHomi Bhabha National Institute · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: Sedation is essential during invasive mechanical ventilation, and conventionally intravenous analgesic and sedative drugs are used. Sedation with inhaled anesthetics using anesthesia conserving device (ACD) is an alternative. There is no data on the safety and ease of use of AnaConDa™ from India. Materials and methods: After IEC approval and informed consent, we used AnaConDa™-S for Isoflurane sedation in 50 hemodynamically stable (need for <0.5 µg/kg/min of Noradrenaline infusion), ASA I and II patients aged 18-80 years, undergoing elective mechanical ventilation for up to 24 hours after elective oncosurgeries. Patients with mental obtundation (GCS <14), or if pregnant, were excluded. The primary outcome was time spent between RASS scores of -3 and -4, while secondary outcomes were incidence of delirium, technical problems with AnaConDa™, and adverse systemic effects of isoflurane. Bolus doses of isoflurane 0.2-0.5 mL were given if the Richmond agitation sedation scale (RASS) score was not achieved. Results: Fifty patients received isoflurane infusion for a median of 720 (IQR 630-900) minutes, and all remained in the target sedation range. Median time to awakening [19 (IQR, 5-85) minutes], to follow simple verbal commands [20 (IQR 5-180) minutes], and extubation after stopping the infusion of isoflurane was quick [100 (10-470) minutes]. All patients remained hemodynamically stable. None of the patients had delirium. Conclusion: Target sedation levels were achieved with initial boluses of isoflurane using AnaConDa™-S. Isoflurane sedation delivery using AnaConDa™-S is safe and feasible. How to cite this article: Kulkarni AP, Bhosale SJ, Kalvit KR, Sahu TK, Mohanty R, Dhas MM, et al. Safety and Feasibility of AnaConDa™ to Deliver Inhaled Isoflurane for Sedation in Patients Undergoing Elective Postoperative Mechanical Ventilation: A Prospective, Open-label, Interventional Trial (INSTINCT I Study). Indian J Crit Care Med 2022;26(8):906-912.

Indexed as

Anesthesia conserving deviceDeliriumInhaled sedationMechanical ventilationRichmond agitation sedation scale score

Identifiers

PMID36042768
PMCPMC9363797
OpenAlexW4293900562

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.