Inhalational volatile-based sedation for COVID-19 pneumonia and ARDS

Intensive Care Med. 2020 Aug;46(8):1563-1566. doi: 10.1007/s00134-020-06154-8. Epub 2020 Jun 25.


Hospitals worldwide are experiencing a shortage in essential intravenous sedative medications. This is attributable to high number and high sedative needs of COVID-19 critical care patients with disruption of drug supply chains. Inhaled volatile anesthetic agents are an abundant resource and readily implementable solution for providing ICU sedation. Inhaled volatile agents may also provide important pulmonary benefits for COVID-19 patients with ARDS that could improve gas exchange and reduce time spent on a ventilator. We review the use of volatile agents, and provide a technical overview and algorithm for administering inhaled volatile-based sedation in ICUs.

Keywords: ARDS; COVID-19; Sedation; Ventilation; Volatile anesthetics.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anesthetics, Inhalation* / administration & dosage
  • Anesthetics, Inhalation* / adverse effects
  • Anesthetics, Intravenous / supply & distribution
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Isoflurane
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / therapy*
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / therapy*
  • SARS-CoV-2
  • Sevoflurane / adverse effects


  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Hypnotics and Sedatives
  • Sevoflurane
  • Isoflurane