The Use of Volatile Anesthetics as Sedatives for Acute Respiratory Distress Syndrome

Sophia Koutsogiannaki, Motomu Shimaoka, Koichi Yuki, Sophia Koutsogiannaki, Motomu Shimaoka, Koichi Yuki

Abstract

Acute respiratory distress syndrome (ARDS) remains to pose a high morbidity and mortality without any targeted therapies. Sedation, usually given intravenously, is an important part of clinical practice in intensive care unit (ICU), and the effect of sedatives on patients' outcomes has been studied intensively. Although volatile anesthetics are not routine sedatives in ICU, preclinical and clinical studies suggested their potential benefit in pulmonary pathophysiology. This review will summarize the current knowledge of ARDS and the role of volatile anesthetic sedation in this setting from both clinical and mechanistic standpoints. In addition, we will review the infrastructure to use volatile anesthetics.

Conflict of interest statement

Conflict of Interest No.

Figures

Figure 1:. The scheme of alveolus in…
Figure 1:. The scheme of alveolus in healthy and injured lung.
In healthy lung, alveolar fluid clearance occurs normally with the help of Na/K ATPase, Na channel (ENaC) and aquaporin (AQP5). TGF-β is not activated yet. In injured lung, ENaC is internalized and AQP5 expression is reduced, resulting in the impairment of alveolar fluid clearance. Integrin αvβ6 activates TGF-β. Also HMGB1 is released from dying cells and binds to RAGE on the alveolar epithelial cells. Neutrophils also have RAGE on their surface, and HMGB1 acts as a neutrophil chemoattractant.
Figure 2:. The AnaConDa device and its…
Figure 2:. The AnaConDa device and its setup.
(A, B) The design of the AnaConDa device. (C) The setup for the AnaConDa device use

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Source: PubMed

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