P0043 / #586: INHALED SEDATION WITH SEVOFLURANE IN CRITICALLY ILL CHILDREN DURING ECMO: REPORT OF TWO CASES.

Aims & Objectives: There are no previous reports about inhaled sedation in children undergoing ECMO. The objective is to assess the effectiveness and safety of sevoflurane during ECMO in two pediatric patients. Methods: Sevoflurane was administered through an anesthetic device (AnaConDa®) connected to a ventilator. An anesthesia gas analyzer monitor was continuously measuring the end-tidal sevoflurane concentration maintaining a concentration between 0.6 to 1.3%, which corresponds to the minimum alveolar concentration awake level of sevoflurane in children. Sedation treatment, sedation scores, respiratory parameters and adverse effects were registered. Results: Patient 1 was a 13-year-old boy (40 kg of weight) that required veno-venous ECMO due to severe ARDS, achieving tidal volumes of less than 2.5 ml/kg during the first days of ECMO. On day 6 of ECMO, inhaled sevoflurane was used due to difficult sedation and was continued for 11 days (Table 1). Patient 2 was a 7 month-old girl that was placed upon veno-arterial ECMO due to myocarditis. On day 7 of ECMO, sedation was difficult, so sevoflurane was administered and it was continued for 6 days. Sedation was successfully achieved in both patients (Table 1) and patients’ contribution to breathing was possible. The patients did not experience any side effect during sevoflurane treatment or after withdrawal.Conclusions: Administration of sevoflurane sedation during ECMO was effective and safe in both patients. Sevoflurane could be used in children on ECMO with difficult sedation, but new studies with larger populations are required to evaluate this indication.