ArticleIntensive care medicine2015
Benzodiazepine-associated delirium in critically ill adults.
Article in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 113 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Flumazenil on Hypoactive Delirium in the ICU: A Double-Blind, Placebo-Controlled Pilot Study
Impact of Remimazolam Tosilate for General Anesthesia on Prognosis After Bladder Cancer Surgery: a Randomized Controlled Trial
Who cites it
113 citing papers in PubMed, 5 syntheses or guidelines pooled it, 237 citations in OpenAlex.
- Pooled it
- Music intervention for sleep quality in critically ill and surgical patients: a meta-analysis.BMJ open · 2021Pooled it
- Music intervention to relieve anxiety and pain in adults undergoing cardiac surgery: a systematic review and meta-analysis.Open heart · 2021Pooled it
- Drug therapy for delirium in terminally ill adults.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions for preventing intensive care unit delirium in adults.The Cochrane database of systematic reviews · 2018Pooled it
- Effect of the orexin receptor antagonist, suvorexant, on sleep architecture in the early postoperative period following cardiac surgery: a randomized controlled trial.Critical care (London, England) · 2026Trial
- Effect of Remimazolam on Postoperative Delirium in Older Adult Patients Undergoing Orthopedic Surgery: A Prospective Randomized Controlled Clinical Trial.Drug design, development and therapy · 2023Trial
- Association between incident delirium and 28- and 90-day mortality in critically ill adults: a secondary analysis.Critical care (London, England) · 2020Trial
- Effects of propofol, dexmedetomidine, and midazolam on postoperative cognitive dysfunction in elderly patients: a randomized controlled preliminary trial.Chinese medical journal · 2019Trial
- Trial
- Longitudinal Cognitive Recovery After Critical Illness: Trajectories in Sepsis and Non-Sepsis Survivors.Journal of intensive care medicine · 2026Article
- Prevalence and Incidence of Oral Benzodiazepine Use in Hospitalized Surgical Patients: A Retrospective Cohort Study.Annals of surgery · 2026Article
- Phenobarbital as an Adjuvant to benzodiazepines when compared to Single-agent benzodiazepine Treatment (usual care) for Alcohol withdrawal syndrome in the intensive care unit (PASTA): a study protocol.Pilot and feasibility studies · 2026Article
- Potentials and challenges of an integrative medicine protocol in intensive care: the perspective of intensive care nurses.BMC complementary medicine and therapies · 2026Article
- Sedation as an Immunomodulator of Inflammatory Responses in the Lung-Brain Axis of ARDS.International journal of molecular sciences · 2026Review
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Neurological Complications in Intensive Care Units: From Delirium to Long-Term Cognitive Dysfunction-A Narrative Review.Journal of clinical medicine · 2026Review
- Prevention and Treatment of ICU Delirium in Brain Injured Patients.Current neurology and neuroscience reports · 2026Review
- Early Use of Fentanyl Increases Risk of Delirium in Patients Transfer to the intensive Care Unit After Cardiac Surgery Immediately: A Target Trial Emulation.Journal of evidence-based medicine · 2026Article
- A pilot, parallel-group, blinded, placebo-controlled, randomiseCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
53 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe association between benzodiazepine use and delirium risk in the ICU remains unclear. Prior investigations have failed to account for disease severity prior to delirium onset, competing events that may preclude delirium detection, other important delirium risk factors, and an adequate number of patients receiving continuous midazolam. The aim of this study was to address these limitations and evaluate the association between benzodiazepine exposure and ICU delirium occurrence.
methodsIn a cohort of consecutive critically ill adults, daily mental status was classified as either awake without delirium, delirium, or coma. In a first-order Markov model, multinomial logistic regression analysis was used, which considered five possible outcomes the next day (i.e., awake without delirium, delirium, coma, ICU discharge, and death) and 16 delirium-related covariables, to quantify the association between benzodiazepine use and delirium occurrence the following day.
resultsAmong 1112 patients, 9867 daily transitions occurred. Benzodiazepine administration in an awake patient without delirium was associated with increased risk of delirium the next day [OR 1.04 (per 5 mg of midazolam equivalent administered) 95 % CI 1.02-1.05). When the method of benzodiazepine administration was incorporated in the model, the odds of transitioning to delirium was higher with benzodiazepines given continuously (OR 1.04, 95 % CI 1.03-1.06) compared to benzodiazepines given intermittently (OR 0.97, 95 % CI 0.88-1.05).
conclusionsAfter addressing potential methodological limitations of prior studies, we confirm that benzodiazepine administration increases the risk for delirium in critically ill adults but this association seems to be limited to continuous infusion use only.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.