Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study

Abstract Intraoperative remifentanil reduces postoperative delirium incidence, unlike other opioids; however, its efficacy in medical emergencies with organ failure is unknown. We hypothesized that remifentanil use in nonoperative intensive care unit (ICU) patients requiring ventilatory management w...

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Main Authors: Junpei Haruna, Aki Sasaki, Satoshi Kazuma
Format: Article
Language:English
Published: BMC 2025-03-01
Series:International Journal of Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12245-025-00846-y
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author Junpei Haruna
Aki Sasaki
Satoshi Kazuma
author_facet Junpei Haruna
Aki Sasaki
Satoshi Kazuma
author_sort Junpei Haruna
collection DOAJ
description Abstract Intraoperative remifentanil reduces postoperative delirium incidence, unlike other opioids; however, its efficacy in medical emergencies with organ failure is unknown. We hypothesized that remifentanil use in nonoperative intensive care unit (ICU) patients requiring ventilatory management would improve delirium outcomes. This retrospective study included 95 nonoperative patients with unplanned ICU admissions requiring ventilatory opioids. Delirium was assessed using the Intensive Care Delirium Screening Checklist. Patients were divided into remifentanil and non-remifentanil groups; statistical adjustments were made using propensity score matching and inverse probability weighting. After matching, the remifentanil group had significantly more delirium-free days (DFDs) within 14 days than the non-remifentanil group (8 [5–11] vs. 5 [3–9], p < .001). Adjusted multivariate analysis showed that DFD was significantly increased in the remifentanil group (Odds ratio = 2.639 [95% CI 1.279–5.445]; p = 0.009). Remifentanil use in nonoperative ventilated ICU patients may reduce delirium duration.
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spelling doaj-art-20be5d0f3d7544118bec85ff3ccd189b2025-08-20T02:51:27ZengBMCInternational Journal of Emergency Medicine1865-13802025-03-011811710.1186/s12245-025-00846-yRemifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective studyJunpei Haruna0Aki Sasaki1Satoshi Kazuma2Department of Intensive Care Medicine, School of Medicine, Sapporo Medical UniversityDepartment of Nursing, Sapporo Medical University HospitalDepartment of Intensive Care Medicine, School of Medicine, Sapporo Medical UniversityAbstract Intraoperative remifentanil reduces postoperative delirium incidence, unlike other opioids; however, its efficacy in medical emergencies with organ failure is unknown. We hypothesized that remifentanil use in nonoperative intensive care unit (ICU) patients requiring ventilatory management would improve delirium outcomes. This retrospective study included 95 nonoperative patients with unplanned ICU admissions requiring ventilatory opioids. Delirium was assessed using the Intensive Care Delirium Screening Checklist. Patients were divided into remifentanil and non-remifentanil groups; statistical adjustments were made using propensity score matching and inverse probability weighting. After matching, the remifentanil group had significantly more delirium-free days (DFDs) within 14 days than the non-remifentanil group (8 [5–11] vs. 5 [3–9], p < .001). Adjusted multivariate analysis showed that DFD was significantly increased in the remifentanil group (Odds ratio = 2.639 [95% CI 1.279–5.445]; p = 0.009). Remifentanil use in nonoperative ventilated ICU patients may reduce delirium duration.https://doi.org/10.1186/s12245-025-00846-yRemifentanilDeliriumCritical illness
spellingShingle Junpei Haruna
Aki Sasaki
Satoshi Kazuma
Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study
International Journal of Emergency Medicine
Remifentanil
Delirium
Critical illness
title Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study
title_full Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study
title_fullStr Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study
title_full_unstemmed Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study
title_short Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study
title_sort remifentanil use in critically ill patients requiring mechanical ventilation is associated with increased delirium free days a retrospective study
topic Remifentanil
Delirium
Critical illness
url https://doi.org/10.1186/s12245-025-00846-y
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AT akisasaki remifentaniluseincriticallyillpatientsrequiringmechanicalventilationisassociatedwithincreaseddeliriumfreedaysaretrospectivestudy
AT satoshikazuma remifentaniluseincriticallyillpatientsrequiringmechanicalventilationisassociatedwithincreaseddeliriumfreedaysaretrospectivestudy