Sedating with volatile anaesthetics for COVID-19 and non-COVID-19 acute hypoxaemic respiratory failure patients in ICU (SAVE-ICU): protocol for a randomised clinical trial.
Summary
This multicentre pragmatic RCT will compare inhaled anesthetic sedation versus intravenous sedation in ventilated adults with acute hypoxemic respiratory failure across 15 ICUs in Canada and the USA. Ethics approvals and trial registration are complete, with a knowledge translation plan in place.
Key Findings
- Pragmatic, open-label randomized controlled trial across 15 ICUs in Canada and the USA.
- Enrols mechanically ventilated adults with acute hypoxemic respiratory failure from COVID-19 and non-COVID causes.
- Intervention compares inhaled anesthetic sedation versus intravenous sedation.
- Ethics approvals obtained and registered at ClinicalTrials.gov (NCT04415060); defined dissemination plan.
Clinical Implications
Potential to inform sedation choice (inhaled vs intravenous) affecting ventilator synchrony, time to extubation, and ICU resource utilization in ARDS care.
Why It Matters
If inhaled sedation improves outcomes, it could reshape ICU sedation strategies for ARDS and other acute hypoxemic respiratory failure. The pragmatic, multicentre design enhances external validity.
Limitations
- Open-label design may introduce performance and detection bias.
- Protocol paper: no outcome data yet; potential for crossover or co-interventions in pragmatic settings.
Future Directions
Complete trial enrolment and report patient-centered outcomes (e.g., ventilator-free days, ICU length of stay), safety, and cost-effectiveness; explore subgroups such as ARDS on ECMO.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Protocol of a randomized controlled trial (no outcomes reported yet).
- Study Design
- OTHER