Cathy McKenziehttps://www.sciencedirect.com/science/article/pii/S235255682200114X One for the reading list . Thanks @critcarereviews
Mathieu Desgroseilliers@cathymac40 are you using anesthetic gases in your unit ?
@matdesgro no not yet, am not convinced yet- are you?
@cathymac40 neither am I. We don’t plan to use it routinely for the near futur
But we look to buy device allowing their administration. If we use it, at the moment, it will be for specific case like refractory status asthmaticus / bronchospasm.
Can become handy in a very few situations. Might be prepared 😂
@matdesgro yes I think you are correct, it will have specific indications. Although I am slightly concerned that adding another method of sedation only distracts from general sedation practice which needs much improvement.
Cannot agree more ! Their place would probably be a niche use for specific indications rather than wide use.
Also I wondering the impact of anesthetic on circadian rythme… this could lead to problems latter on.
Not to mention the close relationship between sedation level & ventilator parameters. There would be no “fine tuning” of sedation level without impacting ventilation. This could lead to use of IV sedation anyway. Don’t seem a win-win situation to me…
#A2Fbundle need to be implemented & reinforced on a daily basis. That’s probably one of the few things we do in #ICU that make a real difference. No matter the sedation agent used
SarahMCooke@matdesgro @cathymac40 we only use it for refractory asthma and bronchospasm, mostly under the direct supervision of our ECMO team, and recently with inreach support from them, as part of the work up once referred. If ECMO cannulation and full anticoagulation are avoided, then I suspect this "may" be the sweet spot? With a paucity of evidence in the context of high demand for services and staffing/skillmix challenges, we need to be careful of drift.......