Sedating With Volatile Anesthetic Agents in Critically Ill COVID‑19 Patients in ICU: Effects On Ventilatory Parameters And Survival (The SAVE-ICU trial)
Up to 40% of COVID‑19 patients can incur severe lung failure needing life-saving supportive care using a ventilator (breathing machine) to treat dangerously low oxygen levels. Unfortunately, 40 to 80% of ventilated patients with COVID‑19 will die despite best medical care. All patients needing a ventilator require intravenous sedative or sleep inducing medications to tolerate this uncomfortable procedure. High volume of COVID‑19 patients needing life saving ventilation and high quantities of sedative medications consumed by these patients has led to a worldwide shortage in intravenous sedative drugs. An alternative method for delivering sedation that can ease pressure on intravenous sedation stocks and possibly accelerate patient recovery is by using inhaled volatile anesthetic agents. Inhaled volatiles are used safely every day in operating rooms, widely available and cheap when providing sedation to ventilated COVID‑19 patients. Inhaled volatiles have also shown to reduce lung inflammation and improve oxygen levels that may reduce time spent on a ventilator and improve survival in COVID‑19 patients with severe lung injury. Our objective is to evaluate differences in time spent on a ventilator, time spent in intensive care units and survival in adult patients with known or suspected COVID‑19 who receive either inhaled or intravenous sedation. After hospital discharge, we will also interview survivors and assess for any differences in satisfaction and activities of daily living between patients who received the two types of sedation. This study is unique and first to addresses the drug shortage issue that all hospitals are facing, and provides a readily available and tested solution. It also provides a potentially effective treatment to improve outcomes for our sickest COVID‑19 patients in the absence of an effective vaccine or other therapy.