Remifentanil-based sedation to treat noninvasive ventilation failure: a preliminary study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-01

AUTHORS

Jean-Michel Constantin, Eric Schneider, Sophie Cayot-Constantin, Renaud Guerin, Francois Bannier, Emmanuel Futier, Jean-Etienne Bazin

ABSTRACT

OBJECTIVE: To assess the feasibility and safety of remifentanil-based sedation during noninvasive ventilation (NIV) in patients with NIV failure. DESIGN AND SETTING: Prospective clinical investigation in a 16-bed intensive care unit of a university hospital in France. PATIENTS: Thirteen patients in NIV failure due to discomfort and/or refusal to continue this ventilatory support: 10 with acute respiratory failure and 3 with acute hypercapnic respiratory failure. INTERVENTION: Patients were administered methylene blue and were sedated (Ramsay scale 2-3) by a continuous perfusion of remifentanil during NIV. Cardiorespiratory and ventilatory parameters, blood gas analysis, and adverse events were prospectively recorded. MEASUREMENTS AND RESULTS: The 13 patients received a total of 125 NIV sessions, totaling 1200 h, of NIV under remifentanil-based sedation (mean remifentanil dose 0.1+/-0.03 microg/kg per minute). Three patients also required propofol. PaO2/FIO2 ratio increased from 134+/-69 to 187+/-43 mmHg after 1 h. In patients with acute respiratory failure respiratory rate decreased from 34+/-12 per minute before remifentanil to 25+/-4 per minute after 1h. In the three patients with acute hypercapnic respiratory failure PaCO2 decreased from 69+/-7 to 42+/-5 mmHg. Four patients required endotracheal intubation without aspiration pneumonia. Twelve of the 13 patients left the ICU. CONCLUSION: This pilot study shows that remifentanil-based sedation is safe and effective in the treatment of NIV failure due to low tolerance. More... »

PAGES

82-87

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-006-0447-4

DOI

http://dx.doi.org/10.1007/s00134-006-0447-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1035879747

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17103141


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