Effect of propofol versus midazolam on short-term outcomes in patients with sepsis-associated acute respiratory distress syndrome

Effect of propofol versus midazolam on short-term outcomes in patients with sepsis-associated acute respiratory distress syndrome. Download PDF Abstract Propofol and midazolam are commonly used sedatives for mechanically ventilated patients in the Intensive Care Unit (ICU); however, there remains a lack of research on the impact of these two drugs on the prognosis of patients with sepsis-associated Acute Respiratory Distress Syndrome(S-ARDS). A statistical analysis was conducted on 4692 patients with S-ARDS in the Medical Information Mart for Intensive Care IV database(MIMIC-IV).

The baseline characteristics of the patients were grouped according to the use of two sedative drugs, propofol and midazolam alone. Cox proportional hazards models, logistic regression models and PSM analysis were used to compare the effects of propofol and midazolam on the short-term outcomes of patients with S-ARDS, including 30-day mortality, 90-day mortality, and duration of mechanical ventilation. In this study, a total of 4692 patients were included in the statistical analysis, of whom 1081 were on midazolam and 3611 on propofol.

Compared with the midazolam group, the propofol group had a lower 30-day mortality rate [HR = 0.592 (95% CI 0.518–0.676, P < 0.001)] and a lower 90-day mortality rate [HR = 0.581 (95% CI 0.513–0.657, P < 0.001)]. The propofol group had a shorter duration of invasive mechanical ventilation compared with the midazolam group [OR = 0.741 (95% CI 0.633–0.869, P < 0.001)], indicating more ventilator-free days in the propofol group. The Kaplan Meier curve showed a lower probability of 90-day survival in the midazolam group (P < 0.001).

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