Inhaled volatile anesthetics in the intensive care unit  

作　　者：Erin D Wieruszewski Mariam ElSaban Patrick M Wieruszewski Nathan J Smischney 

机构地区：[1]Department of Pharmacy,Mayo Clinic,Rochester,MN 55905,United States [2]Anesthesiology and Perioperative Medicine,Mayo Clinic,Rochester,MN 55905,United States [3]Department of Anesthesiology&Perioperative Medicine,Mayo Clinic,Rochester,MN 55905,United States

出　　处：《World Journal of Critical Care Medicine》2024年第1期28-39,共12页世界重症医学杂志

摘　　要：The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend beyond traditional confines of the operating theatres,finding diverse applications in intensive care settings.In the dynamic landscape of intensive care,volatile anesthetics emerge as a promising avenue for addressing complex sedation requirements,managing refractory lung pathologies including acute respiratory distress syndrome and status asthmaticus,conditions of high sedative requirements including burns,high opioid or alcohol use and neurological conditions such as status epilepticus.Volatile anesthetics can be administered through either inhaled route via anesthetic machines/devices or through extracorporeal membrane oxygenation circuitry,providing intensivists with multiple options to tailor therapy.Furthermore,their unique pharmacokinetic profiles render them titratable and empower clinicians to individualize management with heightened accuracy,mitigating risks associated with conventional sedation modalities.Despite the amounting enthusiasm for the use of these therapies,barriers to widespread utilization include expanding equipment availability,staff familiarity and training of safe use.This article delves into the realm of applying inhaled volatile anesthetics in the intensive care unit through discussing their pharmacology,administration considerations in intensive care settings,complication considerations,and listing indications and evidence of the use of volatile anesthetics in the critically ill patient population.

关 键 词：ANESTHESIA Critical care Mechanical ventilation SEDATION Volatile anesthetics SEDATIVE 

分 类 号：R-05[医药卫生] TP18[自动化与计算机技术—控制理论与控制工程]