JAMA

Inhaled vs. IV sedation in ARDS patients: Randomized trial compares outcomes

March 21, 2025

Among patients with moderate to severe ARDS, inhaled sevoflurane was associated with worse clinical outcomes than propofol.

Study details: The phase 3, randomized, open-label SESAR trial, conducted across 37 French ICUs from 2020 to 2023, included 687 adults with early moderate to severe ARDS and compared inhaled sevoflurane (n=346) with IV propofol (n=341) for sedation for up to 7 days.

Results: The sevoflurane group had 2.1 fewer ventilator-free days at 28 days compared with the propofol group (standardized hazard ratio [HR], 0.76, 95% confidence interval [CI], 0.50-0.97). Additionally, the 90-day survival rate was lower in the sevoflurane group (47.1% vs. 55.7%; HR 1.31). Sevoflurane was also associated with higher 7-day mortality (19.4% vs. 13.5%) and fewer ICU-free days at 28 days.

Source:

Jabaudon M, et al; SESAR Trial Investigators. (2025, March 18). JAMA. Inhaled Sedation in Acute Respiratory Distress Syndrome: The SESAR Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40098564/