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. 2023 Oct 8;12(19):6401.
doi: 10.3390/jcm12196401.

Usage of Inhalative Sedative for Sedation and Treatment of Patient with Severe Brain Injury in Germany, a Nationwide Survey

Affiliations

Usage of Inhalative Sedative for Sedation and Treatment of Patient with Severe Brain Injury in Germany, a Nationwide Survey

Svea Roxana Roggenbuck et al. J Clin Med. .

Abstract

Brain injured patients often need deep sedation to prevent or treat increased intracranial pressure. The mainly used IV sedatives have side effects and/or high context-sensitive half-lives, limiting their use. Inhalative sedatives have comparatively minor side effects and a brief context-sensitive half-life. Despite the theoretical advantages, evidence in this patient group is lacking. A Germany-wide survey with 21 questions was conducted to find out how widespread the use of inhaled sedation is. An invitation for the survey was sent to 226 leaders of intensive care units (ICU) treating patients with brain injury as listed by the German Society for Neurointensive Care. Eighty-nine participants answered the questionnaire, but not all items were responded to, which resulted in different absolute counts. Most of them (88%) were university or high-level hospital ICU leaders and (67%) were leaders of specialized neuro-ICUs. Of these, 53/81 (65%) use inhalative sedation, and of the remaining 28, 17 reported interest in using this kind of sedation. Isoflurane is used by 43/53 (81%), sevoflurane by 15/53 (28%), and desflurane by 2. Hypotension and mydriasis are the most common reported side effects (25%). The presented survey showed that inhalative sedatives were used in a significant number of intensive care units in Germany to treat severely brain-injured patients.

Keywords: brain injury; critical care; inhalative anesthetics; inhalative sedation; isoflurane; neuromonitoring; sevoflurane; surveys and questionnaires.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Type of ICU as stated by the participants of the survey. Allocation of the participants of the survey to their primary profession of the ICU.
Figure 2
Figure 2
Distribution of user behavior and interest in usage of inhalative sedatives. Of the 81 participants who responded to the main question, 53 said they use anesthetic gases, and of the remaining 28, 17 said they were interested in using them.
Figure 3
Figure 3
Reasons of the participants who did not use inhalative sedatives. The figure shows the reasons for not using inhalative sedatives. Multiple answers were possible.

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