• bispectral index
• brain monitoring
• inhaled anesthetics
• pharmacodynamics
• pharmacokinetics
• sevoflurane

• Anesthesia
• Critical care
• Mechanical ventilation
• Sedation
• Sedative
• Volatile anesthetics

• COVID-19
• acute respiratory distress syndrome
• critical care
• deep sedation
• sevoflurane

• acute respiratory distress syndrome
• inhaled sedation
• intensive care unit
• isoflurane
• sevoflurane

• Anesthetics, Inhalation
• Critical Care
• Humans
• Hypnotics and Sedatives
• Intensive Care Units
• Isoflurane/pharmacology
• Isoflurane/therapeutic use
• Sevoflurane

Current intensive care unit (ICU) sedation guidelines recommend strategies using non-benzodiazepine sedatives. This survey was undertaken to explore inhaled ICU sedation practice in France.

In this national survey, medical directors of French adult ICUs were contacted by phone or email between July and August 2019. ICU medical directors were questioned about the characteristics of their department, their knowledge on inhaled sedation, and practical aspects of inhaled sedation use in their department.

Among the 374 ICUs contacted, 187 provided responses (50%). Most ICU directors (73%) knew about the use of inhaled ICU sedation and 21% used inhaled sedation in their unit, mostly with the Anaesthetic Conserving Device (AnaConDa, Sedana Medical). Most respondents had used volatile agents for sedation for <5 years (63%) and in <20 patients per year (75%), with their main indications being: failure of intravenous sedation, severe asthma or bronchial obstruction, and acute respiratory distress syndrome. Sevoflurane and isoflurane were mainly used (88% and 20%, respectively). The main reasons for not using inhaled ICU sedation were: “device not available” (40%), “lack of medical interest” (37%), “lack of familiarity or knowledge about the technique” (35%) and “elevated cost” (21%). Most respondents (80%) were overall satisfied with the use of inhaled sedation. Almost 75% stated that inhaled sedation was a seducing alternative to intravenous sedation.

This survey highlights the widespread knowledge about inhaled ICU sedation in France but shows its limited use to date. Differences in education and knowledge, as well as the recent and relatively scarce literature on the use of volatile agents in the ICU, might explain the diverse practices that were observed. The low rate of mild adverse effects, as perceived by respondents, and the users’ satisfaction, are promising for this potentially important tool for ICU sedation.

• Anesthetics, Inhalation/administration & dosage
• Drug Utilization/statistics & numerical data
• France
• Health Knowledge, Attitudes, Practice
• Health Personnel/psychology
• Health Personnel/statistics & numerical data
• Humans
• Hypnotics and Sedatives/administration & dosage
• Intensive Care Units/statistics & numerical data
• Isoflurane/administration & dosage
• Sevoflurane/administration & dosage
• Surveys and Questionnaires

• This work was supported by internal funding of the Department of Perioperative medicine, CHU Clermont-Ferrand, France.

Supplemental Digital Content is available in the text.

Patients on extracorporeal support for severe acute respiratory distress syndrome may require a prolonged period of deep sedation. In these patients, volatile sedation may represent a valid alternative to IV drugs. The aim of our study was to describe the feasibility of volatile sedation in a large cohort of acute respiratory distress syndrome patients undergoing venovenous extracorporeal membrane oxygenation and ultraprotective ventilation.

• acute respiratory distress syndrome
• extracorporeal membrane oxygenation
• isoflurane; ultraprotective ventilation
• volatile sedation

• Burns
• acute pain
• airway
• anaesthesia
• critical care
• environmental injuries
• haemodynamic monitoring
• intensive care
• neurobiology
• pain
• pain management
• shock

• Critical illness
• Drug dosing
• Pathophysiologic
• Pharmacokinetic