Intravenous Propofol bests Inhaled Sevoflurane for improving ventilation and survival in ARDS: Study
Researchers have found in a new clinical trial comparing sedation methods for patients with moderate to severe ARDS that inhaled sedation with sevoflurane led to fewer ventilator-free days and lower 90-day survival compared to intravenous propofol.
Whether the use of inhaled or intravenous sedation affects outcomes differentially in mechanically ventilated adults with acute respiratory distress syndrome (ARDS) is unknown. A study determined the efficacy and safety of inhaled sevoflurane compared with intravenous propofol for sedation in patients with ARDS.
Phase 3 randomized, open-label, assessor-blinded clinical trial conducted from May 2020 to October 2023 with 90-day follow-up. Adults with early moderate to severe ARDS (defined by a ratio of Pao2 to the fraction of inspired oxygen of <150 mm Hg with a positive end-expiratory pressure of ≥8 cm H2O) were enrolled in 37 French intensive care units. Patients were randomized to a strategy of inhaled sedation with sevoflurane (intervention group) or to a strategy of intravenous sedation with propofol (control group) for up to 7 days. The primary end point was the number of ventilator-free days at 28 days; the key secondary end point was 90-day survival. Results Of 687 patients enrolled (mean [SD] age, 65 [12] years; 30% female), 346 were randomized to sevoflurane and 341 to propofol.
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