SEvoflurane for Sedation in ARds

NCT ID: NCT04235608

Last Updated: 2024-10-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

700 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-05-03

Study Completion Date

2024-10-02

Brief Summary

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This study evaluates whether a sedation with inhaled sevoflurane will decrease mortality and increase time off the ventilator at 28 days in patients with acute respiratory distress syndrome (ARDS).

Half of the patients will receive inhaled sedation with sevoflurane and the other half will receive intravenous sedation with propofol.

Detailed Description

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PRIMARY OBJECTIVE:

To assess the efficacy of a sedation with inhaled sevoflurane in improving in reducing mortality and morbidity in patients with moderate-severe ARDS in comparison to a control group receiving intravenous sedation with propofol.

PRIMARY HYPOTHESIS:

Inhaled sedation with sevoflurane will improve a composite outcome of mortality and time off the ventilator at 28 days, in patients with moderate-severe ARDS.

The trial will accrue a maximum of 700 patients. Patients will be recruited from participating intensive care units and randomized to the active (inhaled sevoflurane) or control (intravenous propofol).

The overall strategy is to screen and enroll early, every newly intubated, acutely ill or postoperative, patient at each site, using clinically obtained pulse oximetry and blood gases.

By providing superior awakening and extubation times, as well as lung-protective effects from anti-inflammatory and protective effects from epithelial injury, inhaled sevoflurane may hasten recovery from lung injury and improve outcomes.

Conditions

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Acute Respiratory Distress Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Investigator-initiated, multicenter, prospective, randomized, stratified, parallel-group clinical trial with blinded outcome assessment and concealed allocation of patients with moderate-to-severe ARDS to a strategy of inhaled sedation with sevoflurane or to a strategy of current intravenous sedation practice using propofol.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
At each participating center, patients will be followed up for primary and secondary endpoints by members of the research staff who will be unaware of the trial group allocation. Information on whether the primary and secondary outcomes occur will be collected and entered into the electronic web-based case report form (eCRF) by trial or clinical trained personal (clinical research associate), blinded to the allocation group, under the supervision of the local principal investigator (PI) or designee who will also be unaware of the trial group allocation.

Finally, the independent trial statistician and the members of the data monitoring and safety committee (DMSC) will also remain blinded for the allocation during analysis. However, the observation of differences in serious adverse events between the two groups will allow, for safety reasons may the DMSC deem necessary, to unblind allocation groups.

Study Groups

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inhaled sedation with sevoflurane

Inhaled sedation with sevoflurane, as vaporized via the Anesthesia Conserving Device (AnaConDa-S, Sedana Medical, Danderyd, Sweden)

Group Type EXPERIMENTAL

Inhaled sedation with sevoflurane

Intervention Type DRUG

Inhaled sedation with sevoflurane using the Anesthesia Conserving Device (AnaConDa-S, Sedana Medical, Danderyd, Sweden).

intravenous sedation with propofol

intravenous sedation with propofol, as already routinely used in participating ICUs

Group Type ACTIVE_COMPARATOR

intravenous sedation with propofol

Intervention Type DRUG

intravenous sedation with propofol, as already routinely used in participating ICUs.

Interventions

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Inhaled sedation with sevoflurane

Inhaled sedation with sevoflurane using the Anesthesia Conserving Device (AnaConDa-S, Sedana Medical, Danderyd, Sweden).

Intervention Type DRUG

intravenous sedation with propofol

intravenous sedation with propofol, as already routinely used in participating ICUs.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years
* Presence for ≤24 hours of all of the following conditions, within one week of a clinical insult or new or worsening respiratory symptoms:

* PaO2/FiO2 \<150 mmHg with positive end-expiratory pressure (PEEP) ≥8 cmH2O (or, if arterial blood gas not available, SpO2/FiO2 that is equivalent to a PaO2/FiO2 \<150 mmHg with PEEP ≥8 cmH2O and a confirmatory SpO2/FiO2 between 1-6 hours after the initial SpO2/FiO2 determination)
* Bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules
* Respiratory failure not fully explained by cardiac failure or fluid overload; need objective assessment (e.g., echocardiography) to exclude hydrostatic edema if no risk factor present

Exclusion Criteria

* Absence of affiliation to the French Sociale security
* Patient under a tutelage measure or placed under judicial protection
* Continuous sedation with inhaled sevoflurane at enrollment
* Known pregnancy
* Currently receiving ECMO therapy
* Chronic respiratory failure defined as PaCO2 \>60 mmHg in the outpatient setting
* Home mechanical ventilation (non-invasive ventilation or via tracheotomy) except for CPAP/BIPAP used solely for sleep-disordered breathing
* Body mass index \>40 kg/m2
* Chronic liver disease defined as a Child-Pugh score of 12-15
* Expected duration of mechanical ventilation \<48 hours
* Moribund patient, i.e. not expected to survive 24 hours despite intensive care
* Burns \>70% total body surface
* Previous hypersensitivity or anaphylactic reaction to sevoflurane or cisatracurium
* Medical history of malignant hyperthermia
* Long QT syndrome at risk of arrhythmic events
* Medical history of liver disease attributed to previous exposure to a halogenated agent (including sevoflurane)
* Known hypersensitivity to propofol or any of its components
* Known allergy to eggs, egg products, soybeans, and soy products
* Suspected or proven intracranial hypertension
* Tidal volume of 6 mL/kg predicted body weight (PBW) below 200 mL (as recommended by the manufacturer for the use of the AnaConDa-S (Sedana Medical, Danderyd, Sweden)
* Enrollment in another interventional ARDS trial with direct impact on sedation and mechanical ventilation
* Endotracheal ventilation for greater than 120 hours (5 days)
* Persistent bronchopleural fistula despite chest tube drainage
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Clermont-Ferrand

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Matthieu Jabaudon

Role: STUDY_CHAIR

University Hospital, Clermont-Ferrand

Raïko Blondonnet

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Clermont-Ferrand

Jean-Michel Constantin

Role: PRINCIPAL_INVESTIGATOR

APHP - La Pitié Salpêtrière

Antoine Roquilly

Role: PRINCIPAL_INVESTIGATOR

Nantes University Hospital

Samir Jaber

Role: PRINCIPAL_INVESTIGATOR

CHU Montpellier - Saint-Eloi

Virginie Lemiale

Role: PRINCIPAL_INVESTIGATOR

APHP - Saint-Louis

Carole Ichai

Role: PRINCIPAL_INVESTIGATOR

CHU NICE

Lionel Velly

Role: PRINCIPAL_INVESTIGATOR

APHM - La Timone

Stéphanie Bulyez

Role: PRINCIPAL_INVESTIGATOR

CHU Nîmes

Sigismond Lasocki

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Angers

Jean-Pierre Quenot

Role: PRINCIPAL_INVESTIGATOR

CHU Dijon

Thomas Lebouvier

Role: PRINCIPAL_INVESTIGATOR

CHU Rennes

François Legay

Role: PRINCIPAL_INVESTIGATOR

CH Brieuc

Arnaud W. Thille

Role: PRINCIPAL_INVESTIGATOR

CHU Poitiers

Alexandre Lautrette

Role: PRINCIPAL_INVESTIGATOR

Centre Jean-Perrin Clermont-Ferrand

Julien Pottecher

Role: PRINCIPAL_INVESTIGATOR

CHU Strasbourg

Franck Verdonk

Role: PRINCIPAL_INVESTIGATOR

APHP - Saint-Antoine

Christophe Vinsonneau

Role: PRINCIPAL_INVESTIGATOR

CH Béthune

Pierre-Marie Bertrand

Role: PRINCIPAL_INVESTIGATOR

CH Cannes

Mehran Monchi

Role: PRINCIPAL_INVESTIGATOR

CH Melun-Sénart

Joël Cousson

Role: PRINCIPAL_INVESTIGATOR

CHU REIMS

Julien Maizel

Role: PRINCIPAL_INVESTIGATOR

CHU Amiens

Erwan L'Her

Role: PRINCIPAL_INVESTIGATOR

CHU Brest

Belaïd Bouhemad

Role: PRINCIPAL_INVESTIGATOR

CHU Dijon

Boris Jung

Role: PRINCIPAL_INVESTIGATOR

CHU Montpellier - Lapeyronie

Claire Dahyot-Fizelier

Role: PRINCIPAL_INVESTIGATOR

CHU Poitiers

Claire Lhommet

Role: PRINCIPAL_INVESTIGATOR

Hopital Diaconesses - La Croix Simon

Caroline Varillon

Role: PRINCIPAL_INVESTIGATOR

CH Dunkerque

Arthur Durand

Role: PRINCIPAL_INVESTIGATOR

CHU Lille

Marc Gainnier

Role: PRINCIPAL_INVESTIGATOR

APHM - La Timone

Fabien Lambiotte

Role: PRINCIPAL_INVESTIGATOR

Hospital Valenciennes

Julien Lorber

Role: PRINCIPAL_INVESTIGATOR

Hospital, Saint Nazaire

Delphine Brégeaud

Role: PRINCIPAL_INVESTIGATOR

HOSPITAL, SAINTES

Aziz Berrouba

Role: PRINCIPAL_INVESTIGATOR

Hospital Martigues

Julio Badie

Role: PRINCIPAL_INVESTIGATOR

Hospital Belfort

Alexandre Conia

Role: PRINCIPAL_INVESTIGATOR

HOSPITAL, CHARTRES

François Thouy

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Clermont-Ferrand

Locations

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University Hospital

Amiens, , France

Site Status

University Hospital

Angers, , France

Site Status

Hospital Belfort

Belfort, , France

Site Status

Hospital

Béthune, , France

Site Status

Cavale Blanche Hospital - University Hospital

Brest, , France

Site Status

Hospital

Cannes, , France

Site Status

Hospital Chartres

Chartres, , France

Site Status

University Hospital,

Clermont-Ferrand, , France

Site Status

Jean Perrin Comprehensive Cancer Center

Clermont-Ferrand, , France

Site Status

University Hospital

Clermont-Ferrand, , France

Site Status

University Hospital

Dijon, , France

Site Status

Hospital

Dunkirk, , France

Site Status

Salengro Hospital - University Hospital

Lille, , France

Site Status

Timone Hospital - Assistance Publique-Hôpitaux

Marseille, , France

Site Status

Hospital Martigues

Martigues, , France

Site Status

Hospital

Melun, , France

Site Status

Lapeyronie Hospital - University Hospital

Montpellier, , France

Site Status

Saint-Eloi Hospital - University Hospital

Montpellier, , France

Site Status

Hotel Dieu Hospital - University Hospital

Nantes, , France

Site Status

Pasteur 2 Hospital - University Hospital

Nice, , France

Site Status

Carémeaux Hospital - University Hospita

Nîmes, , France

Site Status

Diaconesses - La Croix Simon Hospital

Paris, , France

Site Status

Pitié-Salpêtrière Hospital, - Assistance Publique-Hôpitaux

Paris, , France

Site Status

Saint-Antoine University Hospital - Assistance Publique-Hôpitaux

Paris, , France

Site Status

Saint-Louis University Hospital - Assistance Publique-Hôpitaux

Paris, , France

Site Status

University Hospital

Poitiers, , France

Site Status

University Hospital

Reims, , France

Site Status

University Hospital

Rennes, , France

Site Status

Hospital

Saint-Brieuc, , France

Site Status

Hospital Saint-Nazaire

Saint-Nazaire, , France

Site Status

Hospital

Saintes, , France

Site Status

Hautepierre Hospital, University Hospitals

Strasbourg, , France

Site Status

Hospital Valenciennes

Valenciennes, , France

Site Status

Countries

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France

References

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Jabaudon M, Quenot JP, Badie J, Audard J, Jaber S, Rieu B, Varillon C, Monsel A, Thouy F, Lorber J, Cousson J, Bulyez S, Bourenne J, Sboui G, Lhommet C, Lemiale V, Bouhemad B, Brault C, Lasocki S, Legay F, Lebouvier T, Durand A, Pottecher J, Conia A, Bregeaud D, Velly L, Thille AW, Lambiotte F, L'Her E, Monchi M, Roquilly A, Berrouba A, Verdonk F, Chabanne R, Godet T, Garnier M, Blondonnet R, Vernhes J, Sapin V, Borao L, Futier E, Pereira B, Constantin JM; SESAR Trial Investigators. Inhaled Sedation in Acute Respiratory Distress Syndrome: The SESAR Randomized Clinical Trial. JAMA. 2025 May 13;333(18):1608-1617. doi: 10.1001/jama.2025.3169.

Reference Type DERIVED
PMID: 40098564 (View on PubMed)

Other Identifiers

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SESAR - RBHP 2018 JABAUDON

Identifier Type: -

Identifier Source: org_study_id

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