ArticleCureus2026
Assessing the Influence of Propofol Sedation Versus Propofol-Free Sedation on Recovery From Sepsis and Septic Shock in Mechanically Ventilated ICU Patients: A Retrospective, Propensity-Score Matched, Cohort Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
backgroundPropofol-mediated immunosuppression has been postulated in preclinical research, yet translational clinical evidence is lacking. We, therefore, retrospectively evaluated the influence, if any, of propofol versus non-propofol sedation on critical care requirements, prognosis, and risk of re-infection among mechanically ventilated patients with sepsis or septic shock.
methodsThis single-center, retrospective cohort analysis included adult patients admitted to any ICU at our institution from July 2017 through December 2022 with a diagnosis of sepsis or septic shock who required mechanical ventilation with sedation. Patients who received propofol sedation with or without
resultsA total of 615 patients were included, comprising 511 (83.1%) propofol-sedated patients and 104 (16.9%) non-propofol-sedated patients. Prior to PSM, propofol sedation was more common among younger patients (median (IQR) years, 62 (50-72) vs. 66 (58-75), p=0.021). Patients treated for septic shock comprised most of the dataset (n=498, 81.0%). The non-propofol group received fentanyl sedation more commonly (84 (80.8%) vs. 234 (45.8%), p<0.001), though the median duration of fentanyl sedation was longer in the propofol group (1.9 (0.9-4.2) vs. 1.5 (0.4-2.8) days, p=0.012). Median ICU-free days were similar between non-propofol and propofol-sedated groups (median (IQR) days, 6.3 (2.1-14.7) vs. 6.8 (3.3-13.3), p=0.303). The proportion of patients requiring three or four pressor infusions was significantly greater in the non-propofol group (32 (30.8%) vs. 110 (21.5%), p=0.041). The combined hospital or 30-day mortality rate was also higher in the non-propofol group (45 (43.3%) vs. 165 (32.3%), p=0.031). After PSM, fentanyl sedation remained more common in the non-propofol group. Median ICU-free days remained similar between groups, but there were no longer significant differences in extent of vasopressor support required or mortality rates.
conclusionsPropofol-containing sedation was not associated with fewer ICU-free days, poorer prognosis, or greater rate of re-infection among mechanically ventilated patients with sepsis and septic shock. Residual confounding and limited precision preclude exclusion of clinically important benefit or harm. Randomized controlled research is necessary to elucidate the clinical impacts of propofol sedation among mechanically ventilated patients with sepsis and septic shock.
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