{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:14:41Z","timestamp":1777634081380,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Remimazolam (RM) is an ultrashort\u2010acting benzodiazepine with pharmacodynamic properties ideal for procedural sedation in emergency departments (EDs). This study evaluated the safety of RM when used for procedural sedation of American Society of Anesthesiologists (ASA) I\u2013III patients in the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the occurrence of no or mild\/moderate respiratory complications during procedural sedation in patients with ASA scores I, II, and III. Secondarily, to compare clinical characteristics of RM sedations between the ASA groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative improvement study was conducted in 2024 and 2025 at a Danish Level 1 trauma center. RM was administered to ASA I\u2013III patients \u2265\u200912\u2009years of age as procedural sedation by emergency medicine physicians or nurses educated in airway management, RM sedation, and adverse events. Safety was measured by the occurrence of respiratory problems graded as none, mild, moderate, or severe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 540 patients sedated with RM, 95%\u2013100% in ASA I\u2013III had no or mild\/moderate respiratory complications, with ASA I and III being the safest groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.014). ASA III patients had the most potential airway risks, but still experienced fewer severe respiratory complications than ASA II patients (4.7% vs. 1.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). The RM dose was found to be age\u2010, gender\u2010 and ASA score\u2010dependent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RM showed great potential for procedural sedation and was safe for procedural sedation of ASA I\u2013III patients in the ED, with few serious respiratory complications, even in high doses and with high\u2010risk profiles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70306","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:39:24Z","timestamp":1777300764000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between American Society of Anesthesiologists Physical Status Classification System and Remimazolam Sedation Outcomes"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9260-2881","authenticated-orcid":false,"given":"Caroline H.","family":"Brynning","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine and Trauma Center, EMRUn Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7880-6273","authenticated-orcid":false,"given":"Simone P.","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Trauma Center, EMRUn Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-7132","authenticated-orcid":false,"given":"Anne L.","family":"Krarup","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Trauma Center, EMRUn Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5656-402X","authenticated-orcid":false,"given":"Dorte","family":"Melgaard","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Trauma Center, EMRUn Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"issue":"4","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/ACO.0000000000000487","article-title":"Procedural Sedation in the ICU and Emergency Department","volume":"30","author":"Chawla N.","year":"2017","journal-title":"Current Opinion in Anaesthesiology"},{"issue":"2","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.annemergmed.2013.10.015","article-title":"Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department","volume":"63","author":"Godwin S. A.","year":"2014","journal-title":"Annals of Emergency Medicine"},{"issue":"6","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1097\/ACO.0000000000000652","article-title":"Drug Selection for Ambulatory Procedural Sedation","volume":"31","author":"Barends C. R. M.","year":"2018","journal-title":"Current Opinion in Anesthesiology"},{"issue":"3","key":"e_1_2_11_5_1","article-title":"The Rise of Remimazolam: A Review of Pharmacology, Clinical Efficacy, and Safety Profiles","volume":"16","author":"Dessai S.","year":"2024","journal-title":"Cureus"},{"issue":"11","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.23736\/S0375-9393.22.16631-9","article-title":"Remimazolam Versus Traditional Sedatives for Procedural Sedation: A Systematic Review and Meta\u2010Analysis of Efficacy and Safety Outcomes","volume":"88","author":"Tang Y.","year":"2022","journal-title":"Minerva Anestesiol"},{"issue":"12","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jval.2024.10.979","article-title":"EE699 the Benefit of Introducing Remimazolam for Procedural Sedation in Belgian Clinical Practice [Internet]","volume":"27","author":"Mihalik A.","year":"2024","journal-title":"Value in Health"},{"issue":"3","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.gie.2018.04.2351","article-title":"A Phase III Study Evaluating the Efficacy and Safety of Remimazolam (CNS 7056) Compared With Placebo and Midazolam in Patients Undergoing Colonoscopy","volume":"88","author":"Rex D. K.","year":"2018","journal-title":"Gastrointestinal Endoscopy"},{"issue":"3","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.gie.2012.11.039","article-title":"Is the American Society of Anesthesiologists Classification Useful in Risk Stratification for Endoscopic Procedures?","volume":"77","author":"Enestvedt B. K.","year":"2013","journal-title":"Gastrointestinal Endoscopy"},{"issue":"1","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.dld.2020.10.039","article-title":"Safety and Efficacy of Remimazolam in High Risk Colonoscopy: A Randomized Trial","volume":"53","author":"Rex D. K.","year":"2021","journal-title":"Digestive and Liver Disease"},{"issue":"02","key":"e_1_2_11_11_1","article-title":"Nurse Administrated Remimazolam Sedation (NARS) for Endoscopic Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography (ERCP) \u2013 A Prospective Study of 410 Procedures in a Danish University Hospital","volume":"56","author":"Ejstrud P.","year":"2024","journal-title":"Endoscopy"},{"issue":"12","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.61409\/A08240562","article-title":"Effectiveness and Safety of Remimazolam Sedation in the Emergency Department","volume":"72","author":"Andreassen S.","year":"2025","journal-title":"Danish Medical Journal"},{"key":"e_1_2_11_13_1","volume-title":"American Society of Anesthesiologists Physical Status Classification System","author":"Hendrix J. 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H.","year":"2023","journal-title":"Current Medical Research and Opinion"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70306","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.70306","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:03:18Z","timestamp":1777438998000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.70306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/acem.70306"],"URL":"https:\/\/doi.org\/10.1111\/acem.70306","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70306"}}