Respiratory failure & ventilation
Isoflurane-Based Inhaled Sedation in Mechanically Ventilated Adults With Acute Hypoxemic Respiratory Failure: The SAVE-ICU Randomized Clinical Trial
Primary result · All-cause hospital mortalityResult — go to the resultRisk ratio 0.98 95% CI 0.84–1.14Authors' conclusion
In mechanically ventilated adults with AHRF, an inhaled sedation strategy using isoflurane with intravenous adjuncts as clinically needed did not reduce hospital mortality compared with an intravenous sedation strategy.
Study context
- Population
- Adults (≥18 years) receiving sedation for less than 72 hours and receiving mechanical ventilation for acute hypoxemic respiratory failure (AHRF) from non-COVID respiratory failure (Pa o 2 :F io 2 <300 mm Hg) or COVID-19randomized, 780 were included in the primary analysis · inhaled sedation 385 · intravenous sedation 395
- Participants
- 786 adults
- Comparison
- Inhaled sedation vs intravenous sedation
- Inhaled sedationn = 385
- Intravenous sedationn = 395reference
- Primary endpoint
- All-cause hospital mortality
- Follow-up
- Hospital discharge
Methodological details14 intensive care units (ICUs) in Canada
- 14 intensive care units (ICUs) in Canada
Primary result
As reported in the abstract
Risk ratio
0.98
95% CI 0.84–1.14
P = 0.85
Events by treatment group
Inhaled sedation vs intravenous sedation
risk ratio 0.98 (95% CI 0.84–1.14); P = 0.85
Secondary outcomes
| Outcome | Inhaled sedation | Intravenous sedation | Between-group difference (95% CI) | |
|---|---|---|---|---|
| Adjunctive therapies for hypoxemiaMore with inhaled sedation | 63.9% | 55.0% | 8.89% (1.95%–15.83%) | |
| Delirium- and coma-free days · day 14Fewer with inhaled sedation | −0.95 (−1.69 to −0.22) | |||
| −1001020Difference (linear scale) |
ICU-, ventilator-, and hospital-free days
- Similar between groups
Quality-of-life and disability scores · 3 months
- No difference between groups
Concomitant intravenous sedation in the inhaled sedation group · first 14 days after randomization
- Patients in the inhaled sedation group receiving concomitant intravenous sedation on any day
- 49.9% to 55.4%
Prespecified subgroups (age, sex, COVID-19 status)
- No effect modification
Original publication
Isoflurane-Based Inhaled Sedation in Mechanically Ventilated Adults With Acute Hypoxemic Respiratory Failure: The SAVE-ICU Randomized Clinical Trial. JAMA. Published 14 October 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →