Alternative Regimens of Sedation and Analgesia for Mechanically Ventilated Patients in the Surgical Intensive Care Unit
An 82 year old male with paroxysmal atrial fibrillation and HFrEF presented with chest pain requiring cardiac catheterization with subsequent biventricular ICD placement. Patient’s postoperative course was complicated by IV fluid overload resulting in pulmonary edema, which necessitated mechanical ventilation. Fentanyl and propofol were administered for pain and sedation, respectively. Patient became hypotensive, which required Levophed, and attempts to curb propofol resulted in desynchronization with the ventilator. Patient was unable to successfully wean ventilation and was transitioned into palliative care. This presentation will examine alternative sedation and analgesic regimens to optimize cardiopulmonary status for a successful liberation from ventilator support.
Mastromonaco M, Katz E, Soto RG. Alternative regimens of sedation and analgesia for mechanically ventilated patients in the surgical intensive care unit. Oral presentation Anesthesiology 2019. American Society of Anesthesiology, Orlando, FL. October 19-23, 2019.