Inhaled Sedation in Acute Respiratory Distress Syndrome
- Type de publi. : Article dans une revue
- Date de publi. : 18/03/2025
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Auteurs :
Matthieu JabaudonJean-Pierre QuenotJulio BadieJules AudardBenjamin RieuCaroline VarillonAntoine MonselFrançois ThouyJulien LorberJoël CoussonStéphanie BulyezJérémy BourenneGhada SbouiClaire LhommetVirginie LemialeBelaïd BouhemadC. BraultSigismond LasockiFrançois LegayThomas LebouvierArthur DurandJulien PottecherAlexandre ConiaDelphine BrégeaudLionel VellyArnaud W. ThilleFabien LambiotteErwan L'HerMehran MonchiAntoine RoquillyAziz BerroubaFranck VerdonkRussell ChabanneThomas GodetMarc GarnierRaiko BlondonnetJérémy VernhesVincent SapinLucile BoraoEmmanuel FutierBruno PereiraJean-Michel ConstantinMarc GainnierJérémy BourenneBéatrice CrestaAurélie LarosaLionel VellyPierre SimeoneDidier SanchezImane InalMarine ChallierValentine VerdierBénédicte Deluca-BoscJean-Michel ConstantinAntoine MonselCyril QuemeneurSandrine NdingamondzeFanny CharbonnierFranck VerdonkSouad FellousChristophe QuesnelAnne Daguenel-NguyenVirginie LemialeElie AzoulayIgor TheodoseMichael DarmonIsabelle MadeleineJulien Le RoyChristophe VinsonneauGhada SbouiSabine JanowskiMaryline HoudreSarah TollotCatherine SenisDominique DescampsPierre-Marie BertrandMarine AgulloMehran MonchiArezki AgherEric StollMaryse CamusJoël CoussonBruno MourvillierEric MarquisAmandine FargetMélanie GaillardSandy AertsPhilippe BenoitFrançois LegayCatherine BellotNathalie KerneurValéry BourbonneuxLaurent PlevenAude DavyAmélie Le GleutNathalie MercierBénédicte HueMarie-Cécile HerveClément BraultJulien MaizelYoann ZerbibRayan BraikKahina ZidSophie BoddaertYves-Edouard HerpeSigismond LasockiMaeva CampfortSoizic GergaudViviane CassisaAnne Sylvie ScholastiqueValérie DanielErwan L'HerPierre BaillyIsabelle LeduHélène Fortin-PrunierAmandine TaponAxelle CornilletPatricia DiasElsa MenanteauJean-Pierre QuenotPascal AndreuAudrey MassardSolene VillotSamantha Lima PinheiroJean-Baptiste RoudautBelaïd BouhemadNicolas NowobilskiVivien BerthoudHasni Si-AbdelkaderSamir JaberGerald ChanquesAudrey de JongBoris JungAlbert PradesFouad BelafiaJulie CarrMoussa CisseMatthieu ConseilJean-Marc DelayJulien BoudjemaaLaurent CachiaJeanne BoyerAntoine RoquillyKarim AsehnouneClément ProuteauDelphine Flattres Du ChaussoyCécilia LebelAmélie TrichotDominique Demeure Dit LatteYannick HourmantPierre-Joachim MaheLaurence FletCarole IchaiJean-Christophe OrbanChristelle BoczekJustine BellegardeStéphanie BulyezClaire RogerLaurent MullerJean-Yves LefrantSophie LloretAudrey AmbertMathieu ExpertCaroline MauryVirginie ViviezElodie JullianCéline LoiseauChristian MaillardClaire Dahyot-FizelierNadia ImziChristelle PlumereauSabrina SeguinIsabelle PrincetArnaud ThilleJean-Pierre FratRené RobertRémy CoudroyCarole GuignonCéline DelétageNacira BenhamoucheDelphine ChatellierDamien MarieFlorence BoissierAnne VeinsteinThomas LebouvierPhilippe SeguinSophie CaradecJulien PottecherEric NollPierre DiemunschThiên-Nga Chamaraux-TranHabiba MoussaStéphane HecketsweilerArnaud RomoliAlain MeyerNadia DhifMagdalena SzczotAlban PellegrinoAlexandre DebaeneAnne HuttSarah LangClaire LhommetRoland AmathieuThierry LazardGabriel LejourEmmanuelle GuillotCaroline VarillonCaroline BlazejewskiSébastien BeagueMaud VassePauline BoddaertMaxime SamsonRaphael KrouchiCyril FayolleThomas QueruauFrançois BezeSolange TombelleFréderique DanicourtBasile DectotCarole DelattreValentin VergrieteFahima ZidatCélia Komurkiewicz-WellemsVirginie PaquezArthur DurandSaad NseirSylvie BriceClaire DelcourteAmélie CerfLaure MarillerBenjamin RieuRaiko BlondonnetThomas CostilleThierry GillartJean-Baptiste JoffredoAudrey JohannyClémence LouisSébastien PerbetAdrien CarlaMargaux CoudrayLoris GiordanettoMarc BégardCamille BoissyThibaud CammasRussell ChabanneBernard CosserantRomain GrobostKatia LevrierPierre-Antoine PiocheBertille PaquetteGauthier ArpajouJules AudardLucie AupetitgendreSophie CayotRenaud GuerinBenoit BaiettoLaure-Anne SimandEmmanuel FutierJean-Etienne BazinThomas GodetMarc GarnierMatthieu JabaudonBruno PereiraNathalie BourguignonSylvie CosserantPérine VidalGuillaume ChauvetJérémy VernhesVincent SapinDominique MorandCamille TheilliereFrançois ThouyBertrand SouweineClaire DupuisMireille Adda-PernotMarine BereiziatFrederic DueeAlexandre LautretteNathanael EisenmannGhislaine NiezgodzkiRodolphe HilaireRégine ChevrierSonia RucartJulien LorberMaud JonasCéline ChevalierServane VastralJulio BadieLaurent FaivreElodie BouvierCharlotte BourgoinIsabelle RoussezPascale DussertFabien LambiotteMohamed Ali BenbaliHanane FodilJustine LemtiriChaouki BourasHedi DhaouadiNabil El BekiDelphine BregeaudStéphanie VioletteAziz BerroubaGwladys M’boungouEric GerardinRomain BlanchonElodie ProtestiAlexandre ConiaPierre KalfonBénédicte MauchienMartine FerrandièreCharlène Piat
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Organismes :
Hôpital universitaire Robert Debré [Reims]
Nutrition, Métabolismes et Cancer
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Laboratoire de Traitement de l'Information Medicale
Centre Hospitalier Régional Universitaire [Montpellier]
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
Centre Hospitalier Régional Universitaire [Montpellier]
CIC Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
- Publié dans JAMA Cardiology le 25/10/2020
Résumé : Importance Whether the use of inhaled or intravenous sedation affects outcomes differentially in mechanically ventilated adults with acute respiratory distress syndrome (ARDS) is unknown. Objective To determine the efficacy and safety of inhaled sevoflurane compared with intravenous propofol for sedation in patients with ARDS. Design, Setting, and Participants Phase 3 randomized, open-label, assessor-blinded clinical trial conducted from May 2020 to October 2023 with 90-day follow-up. Adults with early moderate to severe ARDS (defined by a ratio of Pao 2 to the fraction of inspired oxygen of <150 mm Hg with a positive end-expiratory pressure of ≥8 cm H 2 O) were enrolled in 37 French intensive care units. Interventions Patients were randomized to a strategy of inhaled sedation with sevoflurane (intervention group) or to a strategy of intravenous sedation with propofol (control group) for up to 7 days. Main Outcomes and Measures The primary end point was the number of ventilator-free days at 28 days; the key secondary end point was 90-day survival. Results Of 687 patients enrolled (mean [SD] age, 65 [12] years; 30% female), 346 were randomized to sevoflurane and 341 to propofol. The median total duration of sedation was 7 days (IQR, 4 to 7) in both groups. The number of ventilator-free days through day 28 was 0.0 days (IQR, 0.0 to 11.9) in the sevoflurane group and 0.0 days (IQR, 0.0 to 18.7) in the propofol group (median difference, −2.1 [95% CI, −3.6 to −0.7]; standardized hazard ratio, 0.76 [95% CI, 0.50 to 0.97]). The 90-day survival rates were 47.1% and 55.7% in the sevoflurane and propofol groups, respectively (hazard ratio, 1.31 [95% CI, 1.05 to 1.62]). Among 4 secondary outcomes, sevoflurane was associated with higher 7-day mortality (19.4% vs 13.5%, respectively; relative risk, 1.44 [95% CI, 1.02 to 2.03]) and fewer intensive care unit–free days through day 28 (median, 0.0 [IQR, 0.0 to 6.0] vs 0.0 [IQR, 0.0 to 15.0]; median difference, –2.5 [95% CI, –3.7 to –1.4]) compared with propofol. Conclusions and Relevance Among patients with moderate to severe ARDS, inhaled sedation with sevoflurane resulted in fewer ventilator-free days at day 28 and lower 90-day survival than sedation with propofol. Trial Registration ClinicalTrials.gov Identifier: NCT04235608
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