ICU sedation, delirium & recovery
Remimazolam Besylate Versus Dexmedetomidine As a Sedative in ICU Patients Undergoing Mechanical Ventilation: A Multicenter, Single-blinded, Randomized, Noninferiority Trial
Authors' conclusion
Remimazolam besylate could provide noninferior sedation as dexmedetomidine with a lower risk of bradycardia for 48 hours in mechanically ventilated patients in the ICU.
Study context
- Population
- Adults under endotracheal intubation mechanical ventilation (MV) in the ICU expected to require sedation for 8–48 hours; 15 ICUs in China299 completed
- Participants
- 314 participants
- Comparison
- Remimazolam besylate vs dexmedetomidine for sedation
- Primary endpoint
- Sedation efficacy rate (target RASS −2 to +1)
Methodological detailsmulticentre, single-blind, noninferiority, Analgesia with continuous IV remifentanil 1.2-9.0 µg/kg/hr
- Multicentre
- Single-blind
- Noninferiority
- Analgesia with continuous IV remifentanil 1.2-9.0 µg/kg/hr
Primary result
As reported in the abstract
Sedation efficacy rate
Remimazolam besylate vs Dexmedetomidine: 95% CI lower limit −3.0% · Remimazolam besylate vs Dexmedetomidine: 95% CI lower limit −2.6%
Secondary outcomes
Remaining secondary endpoints
- No intergroup differences
Safety
Bradycardia
P = 0.029
Remaining adverse events
- No intergroup differences
Original publication
Remimazolam Besylate Versus Dexmedetomidine As a Sedative in ICU Patients Undergoing Mechanical Ventilation: A Multicenter, Single-blinded, Randomized, Noninferiority Trial. Crit Care Med. Published 12 January 2026. doi:10.
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