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Published on: September 24, 2020
Volatile sedation using isoflurane versus intravenous sedation in intensive care unit: a propensity matched case
Romain Tymen1,2,3, Kahaia De Longeaux1, Pierre Bailly1
1Medical Intensive Care Unit, CHU Brest, Brest, 29200, France.
Annals of Intensive Care
|August 2, 2026
Summary
This study found that volatile sedation with isoflurane in the ICU showed similar mortality and adverse events compared to intravenous sedation. These findings support the continued use of isoflurane for intensive care unit sedation.
Area of Science:
- Critical Care Medicine
- Anesthesiology
- Pharmacology
Background:
- Intensive care unit (ICU) sedation commonly uses intravenous hypnotics and opioids.
- Volatile anesthetics like isoflurane are being explored for ICU sedation.
- Concerns exist regarding sevoflurane's impact on mortality in ICUs.
Purpose of the Study:
- To evaluate the impact of volatile sedation using isoflurane in a real-world ICU setting.
- To compare outcomes between volatile (isoflurane) and intravenous (midazolam, propofol) sedation.
- To assess mortality and adverse events associated with different sedation methods.
Main Methods:
- A prospective cohort study using a data warehouse system (ReaSTOC).
- Patients on mechanical ventilation (>24 hours) and sedation (>12 hours) were screened.
- 216 patients on isoflurane sedation were matched with 432 patients on intravenous sedation.
Main Results:
- ICU and hospital mortality rates were comparable between volatile and intravenous sedation groups (40.6% vs 42.3% and 43.5% vs 50.0%, respectively).
- Adverse events, including acute kidney injury and dialysis, were similar across both groups.
- Ventilation duration and ICU length of stay were longer in the volatile sedation group.
Conclusions:
- No significant difference in mortality or adverse events was observed between isoflurane and intravenous sedation.
- These results support the ongoing use of isoflurane for sedation in ICU patients.
- Further research may explore optimizing volatile sedation protocols.
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