Overview
A randomized non-inferior trial comparing remimazolam besylate with propofol for long-term sedation during invasive mechanical ventilation in critically ill patients
Eligibility
Inclusion Criteria:
- Age ≥ 18 and ≤ 80 years;
- Intubated and mechanically ventilated ≤96 hours before enrollment；
- Expected to require continuous invasive ventilation and sedation ≥24 hours;
- Requirement for light to moderate sedation (a RASS score of -3 to 0)
Exclusion Criteria:
- Body mass index (BMI) <18 or >30 kg/m2;
- Allergy or unsuitabilty to any composition of study drugs or remifentanil;
- Living expectancy less than 48 hours；
- Possible surgey in the operating room in 24 hours；
- Myasthenia gravis;
- Serious hepatic dysfunction (CTP 10-15);
- Chronic kidney disease with glomerular filtration rate (GFR) < 29 ml/min/1.73m2;
- Systolic blood pressure less than 90 mm Hg after appropriate intravenous volume replacement and continuous infusions of 2 vasopressors;
- Acute severe neurological disorder and any other condition interfering with RASS assessment;
- Pregnancy or lactation;
- Unstable angina or acute myocardial infarction;
- Left ventricular ejection fraction less than 30%;
- Heart rate less than 50 beats/min;
- Grade 2 , second degree or third degree atrioventricular block in the absence of a pacemaker;
- Abuse of controlled substances or alcohol;
- Other conditions deemed unsuitable to be included;