Acute cardiac care & resuscitation
Comparison of sedation using propofol vs. midazolam in patients admitted to the intensive care unit after extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a multicentre observational study
Authors' conclusion
This multicentre cohort study revealed no significant differences in mechanical ventilation duration, ICU stay length, survival, neurological outcomes, and vasopressor requirement between propofol and midazolam users admitted to the ICU after ECPR for OHCA.
Study context
- Population
- Patients admitted to 36 intensive care units (ICUs) in Japan after extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) of cardiac aetiology, 2013–2018109 matched pairs
- Participants
- 109 vs 109
- Exposure
- Propofol vs midazolam for sedation after ECPR
- Propofol usersn = 109
- Midazolam usersn = 109reference
- Outcome
- Time to liberation from mechanical ventilation and ICU discharge
- Follow-up
- 30-day ICU period
Methodological detailspropensity-score matched, multicentre
- Propensity-score matched
- Multicentre
Main finding
As reported in the abstract
- No significant difference in liberation from mechanical ventilation or ICU discharge
- Propofol users vs Midazolam users: P = 0.882
- Propofol users vs Midazolam users: P = 0.634
- Propensity score-matched (109 matched pairs)
Observational data: associations, not effects.
Further findings
| Outcome | Propofol users | Midazolam users | P value |
|---|---|---|---|
| 30-day survival | 0.399 | 0.398 | P = 0.999 |
| 30-day favourable neurological outcome | 0.176 | 0.185 | P = 0.999 |
30-day survival
- No significant difference
30-day favourable neurological outcome
- No significant difference
Safety
| Outcome | Propofol users | Midazolam users | P value |
|---|---|---|---|
| Vasopressor requirement · within 24-h post-ICU admission | 0.651 | 0.670 | P = 0.784 |
Vasopressor requirement · within 24-h post-ICU admission
- No significant difference
Original publication
Comparison of sedation using propofol vs. midazolam in patients admitted to the intensive care unit after extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a multicentre observational study. Eur Heart J Acute Cardiovasc Care. Published 16 February 2023. doi:10.
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