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AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient

INTRODUCTION: With the AnaConDa™ system, inhalational sedation in the intensive care unit has become popular. The device can be used with common intensive care unit ventilators and is inserted between the Y-piece and the patient. Liquid isoflurane or sevoflurane are delivered by a syringe pump. 90 %...

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Autores principales: Bomberg, Hagen, Groesdonk, Heinrich V., Bellgardt, Martin, Volk, Thomas, Meiser, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823227/
https://www.ncbi.nlm.nih.gov/pubmed/27099825
http://dx.doi.org/10.1186/s40064-016-2065-0
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author Bomberg, Hagen
Groesdonk, Heinrich V.
Bellgardt, Martin
Volk, Thomas
Meiser, Andreas
author_facet Bomberg, Hagen
Groesdonk, Heinrich V.
Bellgardt, Martin
Volk, Thomas
Meiser, Andreas
author_sort Bomberg, Hagen
collection PubMed
description INTRODUCTION: With the AnaConDa™ system, inhalational sedation in the intensive care unit has become popular. The device can be used with common intensive care unit ventilators and is inserted between the Y-piece and the patient. Liquid isoflurane or sevoflurane are delivered by a syringe pump. 90 % of anesthetic exhaled by the patient is absorbed by a reflector and resupplied during the next inspiration. The new Mirus™ system also uses a reflector. Its control unit identifies end-tidal concentrations from the flow, injects anesthetics during early inspiration, controls anesthetic concentrations automatically, and can also apply desflurane. The AnaConDa™ and Mirus™ system are certified ‘conformité établi’, however, little is known about the Mirus™ and case reports are still lacking. CASE DESCRIPTION: We used the Mirus™ with desflurane for 24 h in a patient suffering from acute respiratory distress syndrome. The patient was treated with kinetic lateral rotational therapy. While deeply sedated, our patient breathed 9.0–12.0 l min(−1) spontaneously. Thereafter, awakening and wash-out were considerably shorter than after isoflurane in the same patient with AnaConDa™. There were no major problems during the sedation. However, consumption of desflurane was high. CONCLUSION: Desflurane sedation with the Mirus™ seems promising, but the reflector should be improved to absorb and resupply more of the anesthetic agent.
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spelling pubmed-48232272016-04-20 AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient Bomberg, Hagen Groesdonk, Heinrich V. Bellgardt, Martin Volk, Thomas Meiser, Andreas Springerplus Case Study INTRODUCTION: With the AnaConDa™ system, inhalational sedation in the intensive care unit has become popular. The device can be used with common intensive care unit ventilators and is inserted between the Y-piece and the patient. Liquid isoflurane or sevoflurane are delivered by a syringe pump. 90 % of anesthetic exhaled by the patient is absorbed by a reflector and resupplied during the next inspiration. The new Mirus™ system also uses a reflector. Its control unit identifies end-tidal concentrations from the flow, injects anesthetics during early inspiration, controls anesthetic concentrations automatically, and can also apply desflurane. The AnaConDa™ and Mirus™ system are certified ‘conformité établi’, however, little is known about the Mirus™ and case reports are still lacking. CASE DESCRIPTION: We used the Mirus™ with desflurane for 24 h in a patient suffering from acute respiratory distress syndrome. The patient was treated with kinetic lateral rotational therapy. While deeply sedated, our patient breathed 9.0–12.0 l min(−1) spontaneously. Thereafter, awakening and wash-out were considerably shorter than after isoflurane in the same patient with AnaConDa™. There were no major problems during the sedation. However, consumption of desflurane was high. CONCLUSION: Desflurane sedation with the Mirus™ seems promising, but the reflector should be improved to absorb and resupply more of the anesthetic agent. Springer International Publishing 2016-04-06 /pmc/articles/PMC4823227/ /pubmed/27099825 http://dx.doi.org/10.1186/s40064-016-2065-0 Text en © Bomberg et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Study
Bomberg, Hagen
Groesdonk, Heinrich V.
Bellgardt, Martin
Volk, Thomas
Meiser, Andreas
AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
title AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
title_full AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
title_fullStr AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
title_full_unstemmed AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
title_short AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
title_sort anaconda™ and mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient
topic Case Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823227/
https://www.ncbi.nlm.nih.gov/pubmed/27099825
http://dx.doi.org/10.1186/s40064-016-2065-0
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