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Inhaled anesthetic agent sedation in the ICU and trace gas concentrations: a review

  • Narrative review paper
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Abstract

There is a growing interest in the use of volatile anesthetics for inhalational sedation of adult critically ill patients in the ICU. Its safety and efficacy has been demonstrated in various studies and technical equipment such as the anaesthetic conserving device (AnaConDa™; Sedana Medical, Uppsala, Sweden) or the MIRUS™ system (Pall Medical, Dreieich, Germany) have significantly simplified the application of volatile anesthetics in the ICU. However, the personnel’s exposure to waste anesthetic gas during daily work is possibly disadvantageous, because there is still uncertainty about potential health risks. The fact that average threshold limit concentrations for isoflurane, sevoflurane and desflurane either differ significantly between countries or are not even defined at all, leads to raising concerns among ICU staff. In this review, benefits, risks, and technical aspects of inhalational sedation in the ICU are discussed. Further, the potential health effects of occupational long-term low-concentration agent exposure, the staffs’ exposure levels in clinical practice, and strategies to minimize the individual gas exposure are reviewed.

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Authors and Affiliations

  1. Department of Anesthesiology, Ruhr-University Bochum, St. Josef Hospital, Gudrunstraße 56, 44791, Bochum, Germany

    Jennifer Herzog-Niescery, Thomas Peter Weber & Martin Bellgardt

  2. Department of Life Science Engineering, University of Applied Sciences, Wiesenstr. 14, 35390, Giessen, Germany

    Hans-Martin Seipp

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  2. Hans-Martin Seipp
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  3. Thomas Peter Weber
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  4. Martin Bellgardt
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Correspondence to Jennifer Herzog-Niescery.

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Conflict of interest

Herzog-Niescery has received a speaker honorarium from Pall Medical, Dreieich, Germany. Seipp and Weber declares that they have no conflict of interest. Bellgardt has received a speaker honorarium from Pall Medical, Dreieich, Germany.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Herzog-Niescery, J., Seipp, HM., Weber, T.P. et al. Inhaled anesthetic agent sedation in the ICU and trace gas concentrations: a review. J Clin Monit Comput 32, 667–675 (2018). https://doi.org/10.1007/s10877-017-0055-6

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  • DOI: https://doi.org/10.1007/s10877-017-0055-6

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