The effect of sevoflurane and dexmedetomidine on pulmonary mechanics in ICU patients [Yoğun bakım hastalarında sevofluran ve deksmedetomidinin pulmoner mekanikler üzerine etkisi]

Objective: In intensive care unit (ICU) patients, intravenous (iv) and volatile agents are used for sedation. The aim of the present study was to investigate the effects of dexmedetomidine and sevoflurane on pulmonary mechanics in ICU patients with pulmonary disorders. Methods: After approval of the ethical committee and informed consent between the ages of 18-65 years were obtained, 30 patients with an American Society of Anesthesiologist status I-III, who were mechanically ventilated, who had pulmonary disorders and who needed sedation were included in the study. Exclusion criteria were severe hepatic, pulmonary and renal failures; pregnancy; convulsion and/or seizure history; haemodynamic instability and no indication for sedation. Patients were divided into two groups by randomised numbers generated by a computer. For sedation, 0.5%-1% sevoflurane (4-10 mL h-1) was used by an Anaesthetic Conserving Device in Group S (n=15), and iv dexmedetomidine infusion (1 µg-1 kg-1 10 min-1 loading and 0.2-0.7 µg-1 kg-1 h-1 maintenance) was performed in Group D (n=15). Arterial blood gas analysis, airway resistance, positive end-expiratory pressure (PEEP), frequency, tidal volume (TV), peak airway pressure (Ppeak), static pulmonary compliance and end-tidal CO2 values were recorded at baseline, 1, 3, 6, 9, 12 and 24 h. Results: Demographic data, airway resistance, PEEP, frequency, TV, Ppeak and static pulmonary compliance values were similar between the groups. PaCO2 and end-tidal CO2 values were higher in Group S than in Group D. Sedation and patient comfort scores were similar between the two groups. Conclusion: Both sevoflurane and dexmedetomidine are suitable sedative agents in ICU patients with pulmonary diseases. © 2019 by Turkish Anaesthesiology and Intensive Care Society