Propofol vs Midazolam As the Initial Sedation Strategy for Mechanically Ventilated Patients: A Single-Center Experience From Saudi Arabia.

Autor:	Al-Shareef AS; Department of Emergency Medicine, Ministry of National Guard-Health Affairs, Jeddah, SAU.; Research Department, King Abdullah International Medical Research Center, Jeddah, SAU., Babkair K; Department of Emergency Medicine, Ministry of National Guard-Health Affairs, Jeddah, SAU.; Research Department, King Abdullah International Medical Research Center, Jeddah, SAU., Baljoon JM; Department of Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Department of Research, King Abdullah International Medical Research Center, Jeddah, SAU., Alkhamisi TA; Department of Surgery, King Abdullah International Medical Research Center, Jeddah, SAU.; Department of Research, King Abdullah International Medical Research Center, Jeddah, SAU., Altwairqi A; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Department of Research, King Abdullah International Medical Research Center, Jeddah, SAU., Bogari H; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Department of Research, King Abdullah International Medical Research Center, Jeddah, SAU., Altirkistani B; Department of Emergency Medicine, Ministry of National Guard-Health Affairs, Jeddah, SAU.; Department of Research, King Abdullah International Medical Research Center, Jeddah, SAU., Alsukhayri N; Department of Emergency Medicine, Ministry of National Guard-Health Affairs, Jeddah, SAU., Ramadan M; Department of Biomedical Research, King Abdullah International Medical Research Center, Jeddah, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Aug 03; Vol. 16 (8), pp. e66090. Date of Electronic Publication: 2024 Aug 03 (Print Publication: 2024).
DOI:	10.7759/cureus.66090
Abstrakt:	Background Propofol and midazolam are the most common sedative agents used in critical settings. Propofol and midazolam might have different mortality rates after sedation administration. Some studies mention that propofol is associated with a lower mortality rate than midazolam in mechanically ventilated patients, but other studies have contradicting results. This study aims to compare the 28-day mortality of propofol versus midazolam for patients undergoing mechanical ventilation in the National Guard Hospital Health Affairs (NGHA)-Western Region (WR). Methods A retrospective chart review was conducted at (NGHA-WR) from March 2016 to July 2022. The inclusion criteria were those mechanically ventilated patients aged 18 years or older who were admitted to ICU, where they were given either propofol or midazolam as the initial sedative agent. Those who signed DNR (Do Not Resuscitate) or were contraindicated to sedation, such as allergy, were excluded from the study. Data were retrospectively retrieved and obtained from the Hospital Information System (HIS-BestCare, Saudi-Korean Health Informatics Company, Riyadh, Saudi Arabia) and the Office of Data Intelligence. Results There is a significant difference between the type of sedation and the 28-day mortality rate. Midazolam was associated with higher rates of mortality - 104 (47.93%) when compared to propofol - three (14.29%). Also, patients who used midazolam had longer durations of ICU stay compared to propofol, with a mean number of 19.23 days vs 7.55 days, respectively. Conclusion There is a significant difference regarding the 28-day mortality between patients who were given propofol or midazolam as an initial sedative agent for mechanical ventilation ≥ 24 hours. Moreover, the use of propofol is associated with fewer days of being intubated or being in ICU when compared to midazolam. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Abdullah International Medical Research Center (KAIMRC) issued approval IRB/2911/23 and study number NRJ22J/151/05. The Institutional Review Board (IRB) of King Abdullah International Medical Research Center approved this research under IRB approval number IRB/2911/23 and study number NRJ22J/151/05. The study design of this paper was a retrospective case-control study. Thus, no patient consent was required. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Al-Shareef et al.)
Databáze:	MEDLINE
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