Use of MIRUS™ for MAC-driven application of isoflurane, sevoflurane, and desflurane in postoperative ICU patients: a randomized controlled trial

Bellgardt, Martin; Georgevici, Adrian Iustin; Klutzny, Mitja; Drees, Dominik; Meiser, Andreas; Gude, Philipp; Vogelsang, Heike; Weber, Thomas Peter; Herzog-Niescery, Jennifer

doi:10.1186/s13613-019-0594-8

Annals of Intensive Care

Table 2 Ventilation parameters and blood gas analysis during postoperative intravenous and VA sedation

From: Use of MIRUS™ for MAC-driven application of isoflurane, sevoflurane, and desflurane in postoperative ICU patients: a randomized controlled trial

	Intravenous propofol sedation					Inhalational VA sedation					IV vs. VA
	Gr. ISO [n = 10]	Gr. SEVO [n = 10]	Gr. DES [n = 10]	All [n = 30]	p value	ISO [n = 10]	SEVO [n = 10]	DES [n = 10]	All [n = 30]	p value	p value
Ventilation
Resp. rate [n]	14.7 [13.2 to 15.5]	13.9 [12.0 to 15.5]	14.1 [13.8 to 16.1]	14.1 [13.7 to 15.5]	0.588	15.3 [14.3 to 17.8]	14.0 [13.3 to 16.0]	15.1 [14.2 to 18.0]	15.1 [13.9 to 16.9]	0.128	0.065
Tidal vol. [l]	0.58 [0.54 to 0.63]	0.59 [0.54 to 0.64]	0.54 [0.49 to 0.62]	0.59 [0.52 to 0.62]	0.447	0.57 [0.49 to 0.64]	0.62 [0.58 to 0.65]	0.53 [0.48 to 0.63]	0.59 [0.50 to 0.63]	0.385	0.701
RMV [l min⁻¹]	8.6 [7.3 to 9.2]	8.3 [7.4 to 9.0]	8.4 [7.2 to 8.8]	8.4 [7.4 to 9.0]	0.907	9.2 [7.5 to 10.2]	9.1 [7.7 to 9.5]	9.1 [7.4 to 9.6]	9.2 [7.6 to 9.8]	0.804	0.033 (r = 0.275)
etCO₂ [mmHg]	37.9 [34.09 to 38.73]	34.68 [32.68 to 37.56]	35.94 [32.87 to 39.29]	35.98 [33.13 to 38.72]	0.588	38.0 [37.0 to 40.4]	38.7 [32.5 to 41.9]	37.2 [35.5 to 42.1]	38.0 [35.7 to 41.4]	0.983	0.041 (r = 0.263)
P_max [mbar]	20.6 [19.1 to 22.6]	17.9 [14.4 to 20.0]	19.0 [16.4 to 22.3]	19.2 [16.5 to 21.5]	0.069	21.8 [19.7 to 24.4]	18.2 [13.5 to 23.8]	22.1 [20.3 to 23.3]	21.5 [18.3 to 23.8]	0.195	0.056
PEEP [mbar]	5.8 [5.6 to 7.6]	6.9 [5.2 to 8.6]	5.5 [5.0 to 5.8]	5.7 [5.5 to 7.4]	0.086	6.9 [5.7 to 8.0]	5.8 [3.7 to 8.0]	6.2 [5.2 to 7.4]	6.7 [5.6 to 7.9]	0.460	0.488
BGA
pH	7.38 [7.33 to 7.42]	7.38 [7.34 to 7.42]	7.39 [7.36 to 7.44]	7.38 [7.35 to 7.43]	0.854	7.45 [7.42 to 7.50]	7.40 [7.39 to 7.42]	7.46 [7.39 to 7.47]	7.43 [7.39 to 7.47]	0.037 ^*1	0.002 r = 0.396
pH						¹ ISO vs. DES: p = 0.971; SEVO vs. DES: p = 0.052; ISO vs. SEVO: p = 0.011*
BE [mmol l⁻¹]	1.00 [− 1.30 to 2.68]	0.95 [− 0.73 to 1.88]	2.10 [0.28 to 3.90]	1.45 [− 0.25 to 2.68]	0.452	6.20 [2.53 to 6.75]	4.45 [1.88 to 5.95]	6.00 [4.88 to 9.93]	5.60 [3.23 to 6.73]	0.168	< 0.001 r = 0.572

Ventilation parameters were comparable throughout all groups (Gr.) during propofol and VA sedation. However, the respiratory minute volume (RMV) and the end-tidal expiratory CO₂ concentration increased during VA sedation compared to intravenous sedation. Intra- and inter-group comparisons of blood gas analysis (BGA) parameters were not significantly different for hemoglobin (propofol: p = 0.453, VA: p = 0.148; IV vs. VA: p = 0.105), potassium (propofol: p = 0.392, VA: p = 0.309; IV vs. VA: p = 0.628), natrium (propofol: p = 0.402, VA: p = 0.085; IV vs. VA: p = 0.153), and chloride (propofol: p = 0.568, VA: p = 0.361; IV vs. VA: p = 0.830); pH and base excess (BE) increased during VA sedation compared to intravenous sedation. Intragroup comparisons revealed the lowest pH for SEVO during VA sedation
Resp. rate respiratory rate, vol. volume

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