The aim of this retrospective cohort study is to evaluate the effect of lormetazepam versus midazolam on hospital mortality, intensive care unit outcomes and sedation management. The hypothesis is that patients receiving midazolam have a 5% higher hospital mortality in comparison to patients receiving lormetazepam.
Sedation is an integral part of modern intensive care medicine and has seen a tremendous development throughout the last years. Current guideline recommendations are targeted at an awake critically ill patients (target Richmond Agitation-Sedation Scale 0/-1) as early deep sedation has been shown to negatively affect the outcome. Nevertheless, is an adequate and individualized anxiolysis still an important intervention that can be achieved via process optimization, modifications to the infrastructure of the ward and pharmacologic therapy. Bolus application of benzodiazepines is a recommended pharmacologic measure to achieve proper anxiolysis. Midazolam is currently the most commonly used benzodiazepine in European intensive care units. Midazolam accumulates after repetitive application due to its pharmacokinetic properties, which increases the likelihood for side effects and makes targeted sedation increasingly difficult. Lormetazepam is used with increasing frequency as it is eliminated independent of the patients age and has few relevant metabolites. It is therefore thought to be better suited for targeted sedation management, which in turn would be beneficial for the patients. The aim of this retrospective cohort study is to evaluate the effect of lormetazepam versus midazolam on hospital mortality, intensive care unit outcomes and sedation management.
Study Type
OBSERVATIONAL
Enrollment
3,314
In this retrospective analysis we compared critically ill ICU patients receiving midazolam to those receiving lormetazepam.
Hospital Mortality
Proportion of patients that between hospital admission and hospital discharge
Time frame: On average 20 days, for each study subject measured up to study completion day 12-31-2018
Incidence of delirium during the intensive care unit stay
Incidence of delirium diagnosed on the intensive care unit
Time frame: On average 7 days, for each study subject measured up to study completion day 12-31-2018
Duration of delirium during the intensive care unit stay
Duration patients had a delirium on the intensive care unit
Time frame: On average 3 days, for each study subject measured up to study completion day 12-31-2018
Hospital length of stay
Time patients spend admitted to the hospital
Time frame: On average 30 days, for each study subject measured up to study completion day 12-31-2018
Intensive care unit length of stay
Time patients spend admitted to the intensive care unit
Time frame: On average 7 days, for each study subject measured up to study completion day 12-31-2018
Duration of mechanical ventilation
Time patients are mechanically ventilated
Time frame: On average 4 days, for each study subject measured up to study completion day 12-31-2018
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