Isoflurane or propofol sedation in patients with targeted temperature management after cardiopulmonary resuscitation: A single center study

Targeted temperature management improves outcomes in comatose patients after cardiac arrest. Short lasting sedatives might enable rapid awakening after targeted temperature management and therefore early prognostication and extubation. Aim of the present study was to compare sedation with volatile i...

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Bibliographic Details
Published in:Journal of critical care 2018-06, Vol.45, p.40-44
Main Authors: Staudacher, Dawid Leander, Hamilton, Sarah-Kristin, Duerschmied, Daniel, Biever, Paul Marc, Zehender, Manfred, Bode, Christoph, Wengenmayer, Tobias
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Body temperature
Cardiac arrest
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - methods
Cardiovascular disease
Catheters
Coma
Cooling
CPR
Critical care
Female
Heart Arrest - physiopathology
Heart Arrest - therapy
Heart attacks
Humans
Hypnotics and Sedatives - administration & dosage
Hypothermia, Induced - methods
Isoflurane - administration & dosage
Kidney diseases
Liver diseases
Male
Patients
Propofol - administration & dosage
Retrospective Studies
Targeted temperature management
Treatment Outcome
Ventilators
Volatile sedation
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Summary:Targeted temperature management improves outcomes in comatose patients after cardiac arrest. Short lasting sedatives might enable rapid awakening after targeted temperature management and therefore early prognostication and extubation. Aim of the present study was to compare sedation with volatile isoflurane to intravenous propofol. All patients after cardiopulmonary resuscitation undergoing targeted temperature management treated between 01/2014 and 02/2017 at a single tertiary referral hospital were screened. Exclusion criteria included extracorporeal support or a survival below 48 h. Data on 214 patients (median age 66.1 years, 62.6% shockable rhythm, survival 69.6%) are reported, 178 patients on propofol and sufentanil and 36 patients on isoflurane and sufentanil. Median time to first spontaneous breathing (9.3 h vs. 9.5 h, p = .373), median duration on mechanical ventilation in extubated patients (99.4 h vs. 105.7 h, p = .692) and median ICU stay (11.1d vs. 9.8d, p = .320) were similar in patients on propofol or isoflurane, respectively. Findings were confirmed by propensity score matching. Opioid dose was significantly lower in the isoflurane group (p 
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2018.01.014