{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:44:22Z","timestamp":1792514662632,"version":"4.5.0"},"reference-count":8,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2026,12]]},"abstract":"\n Background:<\/jats:title>\n Data comparing benzodiazepine (BZD) to nonbenzodiazepine (non-BZD) sedatives in patients on mechanical ventilation (MV) demonstrate non-BZD sedation is associated with reduced duration of MV and lower mortality and delirium rates in medical and cardiac intensive care unit (ICU) populations. Limited data exist in surgical\/trauma ICU (STICU) populations.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n Evaluate BZD versus non-BZD sedation on days alive and free of MV at 28\u2009days in STICU patients.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This single-center, institutional review board\u2013approved, retrospective cohort study evaluated adult patients admitted to the STICU, intubated for \u226524\u2009hours, and required continuous non-BZD versus BZD sedation in a level I trauma academic hospital. Primary outcome was days alive and free of MV at 28\u2009days. Secondary outcomes included percent of time patients were oversedated and rates of delirium and ventilator-associated pneumonia (VAP). A multivariable model was constructed to determine independent predictors of being alive and free of MV at 28\u2009days.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n After screening, 209 patients were included (BZD, n = 88; non-BZD, n = 121). BZD patients had higher Charlson comorbidity index (CCI) and APACHE II scores. Non-BZD patients had higher rates of traumatic brain injury. Patients receiving non-BZD sedation experienced more days alive and free of MV at 28\u2009days compared with BZD sedation (24 [interquartile range, IQR = 22-25] vs 24 [IQR = 20-25];\n P<\/jats:italic>\n = 0.002). In a multivariable model, including APACHE II score and CCI, non-BZD sedation remained independently associated with increased odds of being alive and free of MV at 28\u2009days (adjusted odds ratio: 6.98;\n P<\/jats:italic>\n = 0.002). In addition, non-BZD sedation was associated with less time being oversedated (\n P<\/jats:italic>\n < 0.0001), less delirium (\n P<\/jats:italic>\n = 0.003), and lower rates of VAP (\n P<\/jats:italic>\n = 0.0007).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance:<\/jats:title>\n In STICU patients requiring MV, non-BZD sedation was associated with more ventilator-free days, less time oversedated, reduced delirium, and reduced VAP. These findings extend prior ICU sedation data into the STICU population supporting the use of non-BZD strategies when clinically appropriate to optimize patient outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10600280261433047","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:51:47Z","timestamp":1775469107000},"page":"1137-1146","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Non-benzodiazepine Versus Benzodiazepine Sedation on Days Alive and Free of Mechanical Ventilation in the Surgical\/Trauma Intensive Care Unit"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3851-4528","authenticated-orcid":false,"given":"Travis","family":"VanOtterloo","sequence":"first","affiliation":[{"name":"University Health, San Antonio, TX, USA"},{"name":"University of Texas at Austin College of Pharmacy, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4918-2576","authenticated-orcid":false,"given":"Kyllie","family":"Ryan-Hummel","sequence":"additional","affiliation":[{"name":"University Health, San Antonio, TX, USA"},{"name":"University of Texas at Austin College of Pharmacy, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2162-3285","authenticated-orcid":false,"given":"Rebecca","family":"Attridge","sequence":"additional","affiliation":[{"name":"The Craneware Group, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Foster","sequence":"additional","affiliation":[{"name":"University Health, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9619-0309","authenticated-orcid":false,"given":"Susannah","family":"Nicholson","sequence":"additional","affiliation":[{"name":"University Health, San Antonio, TX, USA"},{"name":"The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Tondre","sequence":"additional","affiliation":[{"name":"University of the Incarnate Word Feik School of Pharmacy, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savanna","family":"Pittman","sequence":"additional","affiliation":[{"name":"University of the Incarnate Word Feik School of Pharmacy, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3493-8094","authenticated-orcid":false,"given":"Sarah","family":"Berman","sequence":"additional","affiliation":[{"name":"University Health, San Antonio, TX, USA"},{"name":"University of the Incarnate Word Feik School of Pharmacy, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006574"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.56"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.304"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-021-02385-9"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.2.557"},{"key":"e_1_3_3_8_2","unstructured":"Ketamine [package insert]. Hikma Pharmaceuticals; 2022."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a5689f"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280261433047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10600280261433047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280261433047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:17:23Z","timestamp":1792513043000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10600280261433047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":8,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["10.1177\/10600280261433047"],"URL":"https:\/\/doi.org\/10.1177\/10600280261433047","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]}}}