ArticleJournal of intensive care2018
Monitoring of sedation depth in intensive care unit by therapeutic drug monitoring? A prospective observation study of medical intensive care patients.
Article in Journal of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The trial behind it
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Negative drift of sedation depth in critically ill patients receiving constant minimum alveolar concentration of isoflurane, sevoflurane, or desflurane: a randomized controlled trial.Critical care (London, England) · 2021Trial
- Comparison of Midazolam Plasma Concentrations in ARDS Patients with and Without ECMO Support-Prospective Observational Pilot Study.Life (Basel, Switzerland) · 2026Article
- Drug Monitoring of Therapy with Midazolam in Patients with ARDS: A Single-Center Prospective Study.Medicina (Kaunas, Lithuania) · 2026Article
- Analyzing the effects of benzodiazepines on the virulence and biofilm formation of Pseudomonas aeruginosa.Scientific reports · 2025Article
- Sedation management and processed EEG-based solutions during venovenous extracorporeal membrane oxygenation: a narrative review of key challenges and potential benefits.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- Machine-Learning-Aided Advanced Electrochemical Biosensors.Advanced materials (Deerfield Beach, Fla.) · 2025Review
- Metal Oxide Nanocatalysts for the Electrochemical Detection of Propofol.Micromachines · 2025Article
- Pharmacokinetics, Pharmacodynamics, and Side Effects of Midazolam: A Review and Case Example.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Recommended dosages of analgesic and sedative drugs in intensive care result in a low incidence of potentially toxic blood concentrations.Upsala journal of medical sciences · 2024Article
- The Clearance of Midazolam and Metabolites during Continuous Renal Replacement Therapy in Critically Ill Patients with COVID-19.Blood purification · 2024Article
- Hyperinflammation Reduces Midazolam Metabolism in Critically Ill Adults with COVID-19.Clinical pharmacokinetics · 2022Article
- Electroencephalogram-Based Evaluation of Impaired Sedation in Patients with Moderate to Severe COVID-19 ARDS.Journal of clinical medicine · 2022Article
- Safety and Efficacy of Sufentanil and Fentanyl Analgesia in Patients with Traumatic Brain Injury: A Retrospective Study.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Association Between Processed Electroencephalogram-Based Objectively Measured Depth of Sedation and Cerebrovascular Response: A Systematic Scoping Overview of the Human and Animal Literature.Frontiers in neurology · 2021Review
- Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age.International journal of molecular sciences · 2020Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnalgosedation is a cornerstone therapy for mechanically ventilated patients in intensive care units (ICU). To avoid inadequate sedation and its complications, monitoring of analgosedation is of great importance. The aim of this study was to investigate whether monitoring of analgosedative drug concentrations (midazolam and sufentanil) might be beneficial to optimize analgosedation and whether drug serum concentrations correlate with the results of subjective (Richmond Agitation-Sedation Scale [RASS]/Ramsay Sedation Scale) and objective (bispectral (BIS) index) monitoring procedures.
methodsForty-nine intubated, ventilated, and analgosedated critically ill patients treated in ICU were clinically evaluated concerning the depth of sedation using RASS Score, Ramsay Score, and BIS index twice a day. Serum concentrations of midazolam and sufentanil were determined in blood samples drawn at the same time. Clinical and laboratory data were statistically analyzed for correlations using the Spearman's rank correlation coefficient rho (
resultsAverage age of the population was 57.8 ± 16.0 years, 61% of the patients were males. Most frequent causes for ICU treatments were sepsis (22%), pneumonia (22%), or a combination of both (25%). Serum concentrations of midazolam correlated weakly with RASS (
conclusionCorrelations between drug serum concentrations and clinical or neurophysiological monitoring procedures were weak. This might be due to intersubject variability, polypharmacy with drug-drug interactions, and complex metabolism, which can be altered in critically ill patients. Therapeutic drug monitoring is not beneficial to determine depth of sedation in ICU patients.
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Registered trials
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