Sevoflurane sedation worsened outcomes in moderate-to-severe ARDS trial

This review discusses volatile anesthetic sedation, previously proposed to reduce inflammatory lung injury and improve oxygenation in ARDS based on preliminary data. However, the article reports that a recent multicenter randomized controlled trial found sevoflurane sedation reduced ventilator-free days at day 28 and increased mortality compared to propofol in patients with moderate-to-severe ARDS. The authors state that routine clinical use of volatile ICU sedation in ARDS is not currently recommended outside of clinical trials, pending further data on dose, agent selection, and ARDS sub-phenotypes.

Most relevant for: Patients with moderate-to-severe acute respiratory distress syndrome requiring ICU sedation.

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