Sevoflurane administration from extracorporeal membrane oxygenation via the AnaConDa device for a patient with COVID-19: A breakthrough solution for the shortage of intravenous anesthetics.
Yudai Iwasaki, Takuya Shiga, Naoki Hoshi and 5 others
PMID 35780572WHAT IT FOUND
In one patient with severe respiratory failure on ECMO, delivering sevoflurane through the oxygen line reduced the need for multiple intravenous sedatives and allowed lighter sedation without increasing ventilator settings.
This offers a potential workaround for IV anesthetic shortages but remains unproven.
Key findings
01Administering sevoflurane via the ECMO sweep gas allowed clinicians to reduce propofol, fentanyl, and morphine doses while discontinuing midazolam, dexmedetomidine, and norepinephrine.
02The patient achieved a Richmond Agitation-Sedation Scale score of -1 to -2, indicating light sedation, without an increase in mechanical ventilation minute volume.
03The actual concentration of sevoflurane delivered could not be measured because it fell below the detection threshold of the monitoring equipment used.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a single case report, so the results cannot be generalized to other patients. The actual concentration of sevoflurane inhaled by the patient was not measurable and remains unknown. The dosage adjustment table used was created by the authors and has not been validated externally. The patient died from multiple organ failure, so the long-term safety and efficacy of this method are unknown. The method requires specific equipment (AnaConDa, pollution control system) not available in all ICUs.
Declared interests
The authors declared no competing interests. The research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
The easy way to misread this
Do not assume this method is safe or effective for general use. The actual drug concentration was unmeasurable, the dosing table is unvalidated, and the patient died from multi-organ failure, making it impossible to separate the treatment's effects from the disease progression.