Evidence map›Paper›PMID 41988312›Full record

ArticleJournal of thoracic disease2026

Sedation with remimazolam besylate versus midazolam in acute respiratory distress syndrome patients supported by venovenous extracorporeal membrane oxygenation: a study protocol for a multicenter prospective randomized trial.

Manshu Li, Qian Lu, Liang Zhou, Ying Pan, Rui Liang, Lingsong Xie, Runxian Lin, Ming Gao, Dongdong Liu, Xuesong Liu and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Manshu Li *Department of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Qian Lu *Department of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Liang Zhou *Department of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Ying Pan *Department of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Rui LiangDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Lingsong XieDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Runxian LinDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Ming GaoDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Dongdong LiuDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Xuesong LiuDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Sibei ChenDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Rong ZhangDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Xiaoqing LiuDepartment of Critical Care Medicine, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Remimazolam besylate is a novel ultra-short-acting benzodiazepine which offers rapid sedation onset, predictable metabolism, and reduced hemodynamic instability compared to traditional agents. This trial aims to evaluate the sedation efficacy and safety of remimazolam besylate compared to midazolam in acute respiratory distress syndrome (ARDS) patients requiring venovenous extracorporeal membrane oxygenation (VV-ECMO). Methods: This is a multicenter, randomized, single-blind, pilot trial that enrolls adults with ARDS on VV-ECMO. Patients will be randomized 1:1 to protocol-directed sedation with either remimazolam besylate or midazolam, targeting a Richmond Agitation-Sedation Scale (RASS) score of -4. A standardized rescue sedation protocol with dexmedetomidine is predefined. The primary outcome is the percentage of time within the target sedation range (TTR) without rescue sedation. Secondary outcomes are difference in time to awakening between the two groups, ECMO duration, 28-day mortality, delirium incidence, and comprehensive safety evaluation, analyzed using modified intention-to-treat and safety analyses. Discussion: This multicenter, randomized controlled pilot trial evaluates the safety and efficacy of remimazolam besylate versus midazolam for sedation in ARDS patients supported by VV-ECMO. As the first prospective study in this population, it aims to evaluate comparative sedation efficacy while characterizing hemodynamic stability and recovery profiles. The results are expected to offer significant evidence to guide future trials and optimize sedation practices in complex intensive care unit settings. Trial Registration: ChiCTR2500108567.

Indexed as

acute respiratory distress syndrome (ARDS)midazolamRemimazolam besylatesedationvenovenous extracorporeal membrane oxygenation (VV-ECMO)

Identifiers

PMID41988312
PMCPMC13077381

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.