{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:08:22Z","timestamp":1791043702035,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014631","name":"Chartered Society of Forensic Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014631","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Knowledge of risk factors may provide strategies to reduce the high burden of delirium in intensive care unit (ICU) patients. We aimed to compare the risk of delirium after deep sedation with propofol versus midazolam in ICU patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study, ICU patients who were in an unarousable state for \u226524\u2009h due to continuous sedation with propofol and\/or midazolam were included. Patients admitted \u226424\u2009h, those with an acute neurological disorder and those receiving palliative sedation were excluded. ICU patients were assessed daily for delirium during the 7\u00a0days following an unarousable state due to continuous sedation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 950 included patients, 605 (64%) subjects were delirious during the 7\u00a0days after awaking. The proportion of subsequent delirium was higher after midazolam sedation (152\/207 [73%] patients) and after both propofol and midazolam sedation (257\/377 [68%] patients), compared to propofol sedation only (196\/366 [54%] patients). Midazolam sedation (adjusted cause\u2010specific hazard ratio [adj. cause\u2010specific HR] 1.32, 95% confidence interval [CI] 1.05\u20101.66) and propofol and midazolam sedation (adj. cause\u2010specific HR 1.29, 95% CI 1.06\u20101.56) were associated with a higher risk of subsequent delirium compared to propofol sedation only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study among sedated ICU patients suggests that, compared to propofol sedation, midazolam sedation is associated with a higher risk of subsequent delirium. This risk seems more apparent in patients with high cumulative midazolam intravenous doses. Our findings underpin the recommendations of the Society of Critical Care Medicine Pain, Agitation\/sedation, Delirium, Immobility (rehabilitation\/mobilization), and Sleep (disruption) guidelines to use propofol over benzodiazepines for sedation in ICU patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16031","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T07:36:31Z","timestamp":1710401791000},"page":"1471-1479","source":"Crossref","is-referenced-by-count":34,"title":["The risk of delirium after sedation with propofol or midazolam in intensive care unit patients"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2537-8646","authenticated-orcid":false,"given":"Thomas G.","family":"van Gelder","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene J.","family":"van Diem\u2010Zaal","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"},{"name":"Department of Intensive Care Medicine, Franciscus Gasthuis &amp; Vlietland  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra M. A.","family":"Dijkstra\u2010Kersten","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"},{"name":"UMC Utrecht Brain Center, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"de Mul","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"},{"name":"UMC Utrecht Brain Center, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arief","family":"Lalmohamed","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University Medical Center Utrecht Utrecht University  Utrecht the Netherlands"},{"name":"Division of Pharmacoepidemiology &amp; Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjen J. 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