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Role of Sedation and Analgesia During Noninvasive Ventilation

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Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care

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Abstract

Noninvasive ventilation (NIV) is increasingly used in acute respiratory failure in order to avoid complications related to invasive mechanical ventilation. Patient’s compliance is essential to its success, therefore sedative and/or analgesic drugs could be potentially used to reduce discomfort and risk of NIV failure in selected patients. Although sedation and analgesia have a potentially beneficial and even deleterious role, guidelines to specifically address this issue and recommend for or against is relatively missing. Even in the most recent clinical practice guidelines by ERS/ATS for the use of NIV for ARF published in 2017, guidance on sedation and analgesia is missing. Electronic databases (Google Scholar, PubMed, and Cochrane Library) from 2017 to 2019 were searched to find out the recent literature related to sedation in noninvasive ventilation. In this chapter, a brief review of the literature and analysis of the studies related to sedation and analgesia were also done.

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Abbreviations

ACPE:

Acute cardiogenic pulmonary edema

ARF:

Acute respiratory failure

COPD:

Chronic obstructive pulmonary disease

NIV:

Noninvasive ventilation

References

  1. Hillberg RE, Johnson DC. Non-invasive ventilation. N Engl J Med. 1997;337:1746–52.

    Article  CAS  Google Scholar 

  2. Mehta S, Hill NS. Non-invasive ventilation. Am J Respir Crit Care Med. 2001;163:540–77.

    Article  CAS  Google Scholar 

  3. Carlucci A, Richard JC, Wysocki M, Lepage E, Brochard L, SRLF Collaborative Group on Mechanical Ventilation. Non-invasive versus conventional mechanical ventilation. An epidemiologic survey. Am J Respir Crit Care Med. 2001;163:874–80.

    Article  CAS  Google Scholar 

  4. Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374:250–9.

    Article  Google Scholar 

  5. Longrois D, Conti G, Mantz J, Faltlhauser A, Aantaa R, Tonner P. Sedation in non-invasive ventilation: do we know what to do (and why)? Multidiscip Respir Med. 2014;9:56.

    Article  Google Scholar 

  6. Hilbert G, Navalesi P, Girault C. Is sedation safe and beneficial in patients receiving NIV? Yes. Intensive Care Med. 2015;41:1688–91.

    Article  Google Scholar 

  7. Ni Y-N, Wang T, Yu H, Liang B-M, Liang Z-A. The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after extubation. BMC Pulm Med. 2017;17:125.

    Article  Google Scholar 

  8. Conti G, Hill NS, Nava S. Is sedation safe and beneficial in patients receiving NIV? No. Intensive Care Med. 2015;41:1692.

    Article  Google Scholar 

  9. Glossop AJ, Shephard N, Bryden DC, Mills GH. Non-invasive ventilation for weaning, avoiding reintubation after extubation and in the postoperative period: a meta-analysis. Br J Anaesth. 2012;109:305–14.

    Article  CAS  Google Scholar 

  10. Muriel A, Peñuelas O, Frutos-Vivar F, et al. Impact of sedation and analgesia during noninvasive positive pressure ventilation on outcome: a marginal structural model causal analysis. Intensive Care Med. 2015;41:1586.

    Article  CAS  Google Scholar 

  11. Devlin JW, Nava S, Fong JJ, Bahhady I, Hill NS. Survey of sedation practices during noninvasive positive-pressure ventilation to treat acute respiratory failure. Crit Care Med. 2007;35(10):2298–302.

    Article  Google Scholar 

  12. Rocker GM, Mackenzie MG, Williams B, Logan PM. Non invasive positive pressure ventilation: successful outcome in patients with acute lung injury/ARDS. Chest. 1999;115:173–7.

    Article  CAS  Google Scholar 

  13. Constantin JM, Schneider E, Cayot-Constantin S, Guerin R, Bannier F, Futier E, Bazin JE. Remifentanil based sedation to treat noninvasive ventilation failure: a preliminary study. Intensive Care Med. 2007;33:82–7.

    Article  CAS  Google Scholar 

  14. Akada S, Takeda S, Yoshida Y, Sakamoto A. The efficacy of dexmedetomidine in patients with non invasive ventilation: a preliminary study. Anesth Analg. 2008;107:167–70.

    Article  CAS  Google Scholar 

  15. Rocco M, Conti G, Alessandri E, Morelli A, Spadetta G, Laderchi A, Di Santo C, Francavilla S, Pietropaoli P. Rescue treatment for noninvasive ventilation failure due to interface intolerance with remifentanil analgosedation: a pilot study. Intensive Care Med. 2010;36:2060–5.

    Article  Google Scholar 

  16. Clouzeau B, Bui HN, Vargas F, Grenouillet-Delacre M, Guilhon E, Gruson D, Hilbert G. Target-controlled infusion of propofol for sedation in patients with non-invasive ventilation failure due to low tolerance: a preliminary study. Intensive Care Med. 2010;36:1675–80.

    Article  CAS  Google Scholar 

  17. Senoglu N, Oksuz H, Dogan Z, Yildiz H, Demirkiran H, Ekerbicer H. Sedation during noninvasive mechanical ventilation with dexmedetomidine or midazolam: a randomized, double-blind, prospective study. Curr Ther Res. 2010;71:141–53.

    Article  CAS  Google Scholar 

  18. Huang Z, Chen YS, Yang ZL, Liu JY. Dexmedetomidine versus midazolam for the sedation of patients with non-invasive ventilation failure. Intern Med. 2012;51:2299–305.

    Article  CAS  Google Scholar 

  19. Devlin JW, Al-Qadheeb NS, Chi A, Roberts RJ, Qawi I, Garpestad E, Hill NS. Efficacy and safety of early dexmedetomidine during noninvasive ventilation for patients with acute respiratory failure: a randomized, double-blind, placebo-controlled pilot study. Chest. 2014;145:1204–12.

    Article  CAS  Google Scholar 

  20. Vaschetto R, Cammarota G, Colombo D, et al. Effects of propofol on patient-ventilator synchrony and interaction during pressure support ventilation and neurally adjusted ventilatory assist. Crit Care Med. 2014;42(1):74–82.

    Article  CAS  Google Scholar 

  21. Cavaliere F, Antonelli M, Arcangeli A, et al. A low-dose remifentanil infusion is well tolerated for sedation in mechanically ventilated, critically-ill patients. Can J Anaesth. 2002;49:1088–94.

    Article  Google Scholar 

  22. Conti G, Arcangeli A, Antonelli M, et al. Sedation with sufentanil in patients receiving pressure support ventilation has no effects on respiration: a pilot study. Can J Anaesth. 2004;51(5):494–9.

    Article  Google Scholar 

  23. Costa R, Cammarota G, Spinazzola G, et al. Effects of Remifentanil on respiratory drive and timing during PSV and NAVA. Intensive Care Med. 2010;36(2):S346.

    Google Scholar 

  24. Morel DR, Forster A, Gemperle M. Noninvasive evaluation of breathing pattern and thoraco-abdominal motion following the infusion of ketamine or droperidol in humans. Anesthesiology. 1986;65:392–8.

    Article  CAS  Google Scholar 

  25. Miller AC, Jamin CT, Elamin EM. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anestesiol. 2011;77:812–20.

    CAS  PubMed  Google Scholar 

  26. Parashchanka A, Schelfout S, Coppens M. Role of novel drugs in sedation outside the operating room: dexmedetomidine, ketamine and remifentanil. Curr Opin Anaesthesiol. 2014;27:442–7.

    Article  CAS  Google Scholar 

  27. Shutes BL, Gee SW, Sargel CL, Fink KA, Tobias JD. Dexmedetomidine as single continuous sedative during noninvasive ventilation: typical usage, hemodynamic effects, and withdrawal. Pediatr Crit Care Med. 2018;19(4):287–97. https://doi.org/10.1097/PCC.0000000000001451.

    Article  PubMed  Google Scholar 

  28. Venkatraman R, Hungerford JL, Hall MW, Moore-Clingenpeel M, Tobias JD. Dexmedetomidine for sedation during noninvasive ventilation in pediatric patients. Pediatr Crit Care Med. 2017;18(9):831–7. https://doi.org/10.1097/PCC.0000000000001226.

    Article  PubMed  Google Scholar 

  29. Piastra M, Pizza A, Gaddi S, Luca E, Genovese O, Picconi E, De Luca D, Conti G. Dexmedetomidine is effective and safe during NIV in infants and young children with acute respiratory failure. BMC Pediatr. 2018;18(1):282. https://doi.org/10.1186/s12887-018-1256-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Ni YN, Wang T, Yu H, Liang BM, Liang ZA. The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with interface intolerance after extubation. BMC Pulm Med. 2017;17(1):125. Published 2017 Sep 15. https://doi.org/10.1186/s12890-017-0469-4.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, CG, India

    Subrata Kumar Singha & Habib Md Reazaul Karim

  2. Section of Anesthesiology and Intensive Care, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy

    Camilla Calandra & Savino Spadaro

Authors
  1. Subrata Kumar Singha
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  2. Habib Md Reazaul Karim
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  3. Camilla Calandra
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  4. Savino Spadaro
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Editor information

Editors and Affiliations

  1. Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

  2. Department of Pathophysiology and Pulmonary Rehab, Azienda Ospedaliera dei Colli PO Monaldi, Napoli, Italy

    Giuseppe Fiorentino

  3. Innovative Technologies for the Study of Sleep Breathing Disorders, Institute for Biomedical Research and Innovation (IRIB), Italian National Research Council, Palermo, Italy

    Giuseppe Insalaco

  4. Department of Pulmonary and CC Medicine, Lenox Hill Hospital, New York, NY, USA

    Bushra Mina

  5. Department of Respiratory and CC Medicine, First Affiliated Hospital of Chongqing M, Chongqing, China

    Jun Duan

  6. Anestesia and Pediatric Intensive Care Department, University Hospital Policlinico S. Orsola-Malpighi, Bologna, Italy

    Maria Cristina Mondardini

  7. Anestesia and Pediatric Intensive Care Department, University Hospital Policlinico S. Orsola-Malpighi, Bologna, Italy

    Fabio Caramelli

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Singha, S.K., Karim, H.M.R., Calandra, C., Spadaro, S. (2020). Role of Sedation and Analgesia During Noninvasive Ventilation. In: Esquinas, A.M., et al. Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-42998-0_44

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  • DOI: https://doi.org/10.1007/978-3-030-42998-0_44

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42997-3

  • Online ISBN: 978-3-030-42998-0

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