In a fight against the novel coronavirus, Canadian researchers will be looking at whether the inhaled sedatives can replace those that are delivered intravenously in infected patients requiring ventilation.
The multi-center clinical trial aims to address a global shortage of intravenous (IV) sedatives while improving patient outcomes.
According to the researchers, when Covid-19 patients develop severe respiratory failure and need to be ventilated, they require sedation.
“While IV sedatives are currently used, there is concern about global drug shortages, particularly if there’s a second wave of COVID-19 in the fall,” said Marat Slessarev from the Lawson Health Research Institute in Canada.
“Even if we have enough ventilators, we won’t be able to ventilate patients without sedatives,” Slessarev added.
The clinical trial will study the replacement of IV sedatives with inhaled sedatives.
Inhaled sedatives, also called volatiles, are widely available due to their use in operating rooms to sedate patients during surgery.
While they have not been routinely used to sedate patients needing ventilation, early studies suggest they could be safe and even more effective than IV sedatives.
Preliminary studies in non-COVID patients with severe respiratory failure suggest that inhaled sedatives can reduce lung inflammation, shorten the duration of ventilation, and potentially improve survival.
“Inhaled sedatives could, therefore, reduce the pandemic’s strain on ventilator capacity while improving patient outcomes,” Slessarev said.
According to the team, since these drugs are safe, cheap, and readily available, they can easily be used to address IV sedative shortages if found effective.
The researchers will recruit approximately 800 patients from across Canada and the US including patients.
Each patient will be randomized to receive either IV sedatives or inhaled sedatives.
Patient outcomes such as survival and length of ventilation will be compared between the two groups to determine which method of sedation is most effective.
“This is the largest trial of its kind. If inhaled sedatives can shorten the length of ventilation or improve survival in patients with serve respiratory failure, this could cause a paradigm shift in the way we sedate patients in intensive care units (ICUs) around the world,” Slessarev noted.
