Abstract
Background:
Clinically ill COVID-19 intubated patients who require sedation are increasing. Medical institutions are experiencing shortage of propofol. The propofol preparation should be used more appropriately. If there was no clinical problem, the use of volatile inhalation anesthetics in maintaining anesthesia was recommended. The anesthetic conserving device (AnaConDa) is a disposable vaporizer that can deliver volatile inhalation anesthetic used in isoflurane. Recognized common problems with sedatives includes delirium. The purpose of this study was to determine whether sedation with isoflurane caused delirium more than with propofol.
Methods:
The study population included adult patients who were diagnosed with COVID-19, admitted to the ICU, and who were intubated. A retrospective chart review was conducted which compared two groups of COVID-19 patients both with and without the use of isoflurane to explore delirium and determine whether sedation with isoflurane affected mortality rate and the duration of ventilation days compared to sedation with propofol. The study site was a 400-bed hospital in Osaka, Japan. Thirty-three ventilated patients identified the date preceding use of isoflurane (April 25-May 25, 2021) were enrolled in the control group. Thirty-three ventilated patients fitting the inclusion criteria with sedation with isoflurane (May 26, 2021-April 3, 2022) were enrolled in an intervention group. Institutional Review Board (IRB) approval was obtained.
Results:
There was no significant difference in delirium between the groups (81.8 % vs 72.7 %, P > .05). There was no significant difference in the mortality rates between the comparison group and the intervention group (24.24 % vs 27.27 %, P > .05). There was no significant difference in the length of ventilation days (11.3 days vs 9.0 days) between the two groups.
Conclusions:
The use of isoflurane sedation did not differ in delirium, mortality, and ventilation days compared to propofol sedation.
age
Comparison group
Intervention group
Male n (%)
23 (69.7)
25(75.8)
Age, mean ± SD
68.2±11
55.6±13
Comparison group
Intervention group
p Value
Delirium rate, n (%)
27(81.8)
24(72.7)
0.569
Mortality rate, n(%)
8(24.2)
9(27.3)
1
Ventilated days, mean±SD
11.3±8.0
8.9±6.6
0.137
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