Volatile Sedation for Patients With the Acute Respiratory Distress Syndrome

Launched by GUY'S AND ST THOMAS' NHS FOUNDATION TRUST · Aug 22, 2023

Keywords

ClinConnect Summary

This clinical trial is looking at how different types of sedation can affect patients' breathing while they are on a ventilator in the Intensive Care Unit (ICU). Specifically, it will explore the use of both intravenous sedation (like common sedatives given through an IV) and inhaled volatile sedation (similar to the gases used during surgeries). The goal is to see how these sedation methods influence patients' ability to breathe and how well their lungs function while they are being mechanically ventilated.

To take part in this study, participants must be adults who are currently in the ICU with a condition called Acute Respiratory Distress Syndrome (ARDS) and are on invasive mechanical ventilation. They should also have been receiving sedation for a short time and be expected to stay on the ventilator without major changes for the next day. It's important to note that certain conditions, like a history of severe reactions to anesthesia or pregnancy, may exclude someone from participating. Those who join the study can expect close monitoring of their breathing and lung function, helping researchers understand the best sedation options for patients in similar situations.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients admitted to the Intensive Care Unit (ICU)
• • ARDS
• • Invasive mechanical ventilation (IMV)
• • Spontaneous breathing in pressures support mode (PSV) for less than or equal to 48 hours
• • Sedated with intravenous sedation (ie. propofol and / or midazolam and fentanyl or alternate short acting opioid)
• • Anticipated to remain on IMV and PSV and with a stable sedation score for a further 24 hours without planned sedation interruption / spontaneous breathing trial or other significant change in the level of ventilator support
• • Not receiving / anticipated to receive paralysis
• • In supine position
• Exclusion Criteria:
• • Personal or family history of malignant hyperpyrexia
• • Known or suspected elevated intracranial pressure
• • High dose vasopressors (ie. Noradrenaline \> 0.3mcg/kg/min or equivalent)
• • Contra-indication to oesophageal balloon (i.e. oesophageal / upper gastro-intestinal pathology)
• • Pregnancy
• • High dose oral sedatives (e.g. benzodiazepines) or opioids (e.g. oxycodone / oral morphine) which may affect respiratory drive