Advancements in the Application of Remimazolam in ICU
Remimazolam(CNS 7056)is a novel sedative,classified as an ester-based,ultra-short-acting,intravenous benzodiaz-epine.It is primarily utilized for procedural sedation and general anesthesia across various settings such as the operating room,intensive care unit(ICU),and endoscopy suite.Remimazolam boasts several advantages,including rapid onset,quick metabolism,short dura-tion of action,lack of accumulation,non-hepatic and non-renal metabolism,swift reversal by flumazenil,and minimal respiratory and circulatory depression.These features render it superior to traditional benzodiazepine sedatives(eg,propofol,midazolam,alprazolam,and oxazepam)in terms of sedation efficacy.Theoretically,remimazolam can be safely administered for short-term procedures and long-term sedation therapy in the ICU,making it an optimal choice for critically ill patients.However,further research is necessary to explore its clinical application methods and potential adverse effects.To provide a comprehensive reference for clinical research,this study reviews the development background,clinical applications,and pharmacological mechanisms of remimazolam.It mainly focuses on its clinical application in the ICU,including during fiberoptic bronchoscopy,sedation for patients on invasive mechanical ventilation,and sedation in patients with hepatic and renal dysfunction.Additionally,this study analyzes adverse drug reactions,discusses future pros-pects,and concludes that remimazolam is an ideal sedative in the ICU,especially for elderly critically ill patients,and holds the poten-tial to become the preferred first-line choice sedative.
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