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Postconditioning effects following sevoflurane inhalational sedation in the ICU: a pilot study in cardiac surgery patients

Introduction

Volatile anaesthetics using the anesthetic conserving device (ACD) have become an alternative ICU sedation regimen [1, 2]. The purpose of this study was to evaluate postconditioning effects following sevoflurane or propofol administration in patients after elective cardiac surgery.

Methods

Fifty patients either received sevoflurane via ACD or propofol for ICU sedation. The primary endpoint was a change in troponine T (TNT), besides measures of myocardial creatine kinase (CK-MB), N-terminal pro brain natriuretic peptide (NT-proBNP) and haemodynamics. Measure points were set at baseline, end of surgery, 24 hours and 48 hours after surgery.

Results

TNT and CK-MB levels were significantly higher (P < 0.0001) at all measure points compared with baseline in each group, without any significant differences between both groups. NT-proBNP values were significantly lower following sevoflurane at 24 and 48 hours (P < 0.05) compared with propofol (Figure 1).

Figure 1
figure1

NT-proBNP levels.

Conclusion

Postoperative sevoflurane sedation via ACD led to lower NT-proBNP levels at 24 and 48 hours, while TNT and CK-MB values were comparable in both study groups.

References

  1. 1.

    Röhm KD, et al: Short-term sevoflurane sedation using the Anaesthetic Conserving Device after cardiothoracic surgery. Intensive Care Med. 2008, 34: 1673-1679. 10.1007/s00134-008-1157-x.

  2. 2.

    Sackey PV, et al: Prolonged isoflurane sedation of intensive care unit patients with the Anesthetic Conserving Device. Crit Care Med. 2004, 32: 2241-2246.

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Röhm, K., Mayer, J., Boldt, J. et al. Postconditioning effects following sevoflurane inhalational sedation in the ICU: a pilot study in cardiac surgery patients. Crit Care 13, P395 (2009). https://doi.org/10.1186/cc7559

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Keywords

  • Creatine Kinase
  • Sevoflurane
  • Brain Natriuretic Peptide
  • Volatile Anaesthetic
  • Cardiac Surgery Patient