This randomized controlled trial compared remimazolam to propofol for moderate sedation during fiberoptic bronchoscopy (FB) in critically ill patients in the Surgical Intensive Care Unit (SICU) who had pre-existing liver or renal dysfunction.

The study found that remimazolam demonstrated superior efficacy and safety compared to propofol.

While both drugs achieved the target sedation depth in the same median time (5 minutes) and had similar procedural success rates, the remimazolam group showed key advantages:

Better Cardiovascular Stability: A significantly lower incidence of hypotension (3.33% vs. 20%).

Less Drug Supplementation: Required significantly fewer sedation rescues (3.33% vs. 16.67%).

Minimal Organ Impact: Showed a negligible effect on liver and renal function, making it a potentially safer choice for these vulnerable patients.

For critically ill patients with organ dysfunction undergoing bronchoscopy, remimazolam is a more stable, effective, and safer sedative option than propofol.

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