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Effects of Remimazolam on Breathing Patterns, Respiratory Drive, and Inspiratory Effort in Mechanically Ventilated Patients

11 de novembro de 2026 atualizado por: Jian-Xin Zhou, Capital Medical University

Sedatives and analgesics are usually given for analgesic, anxiolytic, or sedating purposes for patients with critical illness, while they inevitably inhibit respiratory and circulatory function. Sometimes, patients receive deep sedation to induce hypoventilation or suppress spontaneous respiratory effort. The sedation level in clinical practice is usually assessed with subjective sedation scoring systems, such as the Richmond Agitation Sedation Scale (RASS). However, studies have found that sedation depth based on RASS is not a reliable marker of respiratory drive during critical illness. In recent years, researchers have proposed to monitor the effects of sedatives and analgesics on respiratory indicators and to implement lung-protective sedation, such as airway occlusion pressure (P0.1), airway occlusion pressure (Pocc). However, different pharmacological characteristics, different depths of sedation, and different sedation regimens among different sedatives and analgesics make a great difference in their effects on respiration. Remimazolam is a new benzodiazepine sedative developed by adding a methyl propionate side chain to the structure of midazolam. As an organic weak base, remimazolam forms a salt with benzenesulfonic acid, which enhances its solubility and stability. The sedative effect of remimazolam primarily occurs through binding to γ-aminobutyric acid type A (GABAA) receptors, opening chloride channels, promoting chloride ion influx, hyperpolarizing neuronal membranes, and thereby suppressing neuronal excitability. The drug acts rapidly, achieving maximum sedation within three minutes after administration. Research on adverse effects of remimazolam remains limited, particularly regarding its impact on respiratory function. Therefore, this study aims to investigate the effects of remimazolam on breathing patterns, respiratory drive, and inspiratory effort in mechanically ventilated patients.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Tipo de estudo

Intervencional

Inscrição (Real)

20

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

      • Beijing, China
        • Beijing Tiantan Hospital

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion criteria:

  • Patients admitted to the ICU after surgery under general anesthesia;
  • Patients with an artificial airway and receiving assisted ventilation in pressure support mode;
  • Patients expected to achieve a sedation depth corresponding to a Richmond Agitation and Sedation Scale (RASS) score of -2 to +1;

Exclusion Criteria:

  • Patients with brainstem tumors or neuromuscular disorders;
  • Patients unable to undergo RASS assessment due to various reasons, such as history of psychiatric disorders (schizophrenia, mania, delirium, cognitive impairment), status epilepticus, or coma;
  • Patients with known or suspected allergy or contraindication to any component of the study drug or opioids;
  • Severe hepatic dysfunction (Child-Pugh class C);
  • Chronic kidney disease (estimated glomerular filtration rate < 60 ml/min/1.73 m²);
  • Mean arterial pressure (MAP) < 65 mmHg, or requiring norepinephrine infusion > 0.5 μg/kg/min to maintain MAP ≥ 65 mmHg;
  • Age <18 years old;
  • Pregnant or breastfeeding women;
  • Body mass index (BMI) <18 kg/m² or >30 kg/m²

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Remimazolam

The investigators conducted a single-arm, prospective physiological trial to assess the respiratory effects of remimazolam. The study enrolled 20 patients receiving invasive mechanical ventilation. Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h. The primary outcomes were changes in breathing pattern (respiratory rate (RR), tidal volume (VT), and minute ventilation (Vmin)), respiratory drive (airway occlusion pressure (P0.1)), and inspiratory effort (pressure muscle index (PMI) and airway occlusion pressure (ΔPocc)) after 0.15 mg/kg/h infusion of remimazolam.

Remimazolam will be infused at 0.15,0.175,0.20,0.225,0.25,0.275, 0.3 mg/kg/h in sequence for 30 minutes at each dose.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Tidal volume
Prazo: At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

The change in tidal volume 30 minutes after remimazolam was infused at a rate of 0.15mg/kg/h compared to the baseline level without the use of sedative drugs.

At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes
Respiratory rate
Prazo: At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

The change in respiratory rate 30 minutes after remimazolam was infused at a rate of 0.15mg/kg/h compared to the baseline level without the use of sedative drugs.

At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes
Minute ventilation
Prazo: At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

The change in minute ventilation 30 minutes after remimazolam was infused at a rate of 0.15mg/kg/h compared to the baseline level without the use of sedative drugs.

At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes
Airway occlusion pressure (P0.1)
Prazo: At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

The change in P0.1 30 minutes after remimazolam was infused at a rate of 0.15mg/kg/h compared to the baseline level without the use of sedative drugs.

At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes
Pressure muscle index (PMI)
Prazo: At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

The change in PMI 30 minutes after remimazolam was infused at a rate of 0.15mg/kg/h compared to the baseline level without the use of sedative drugs.

At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes
Airway occlusion pressure (Pocc)
Prazo: At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

The change in Pocc 30 minutes after remimazolam was infused at a rate of 0.15mg/kg/h compared to the baseline level without the use of sedative drugs.

At baseline (before sedation with remimazolam) and 0.15 mg/kg/h remimazolam continuous infusion for 30 minutes

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Respiratory rate
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, respiratory rate was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)

Changing trends in respiratory rate during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, respiratory rate was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)
Tidal volume
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, tidal volume was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)

Changing trends in tidal volume during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, tidal volume was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)
Minute ventilation
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, minute ventilation was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)

Changing trends in minute ventilation during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, minute ventilation was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)
P0.1
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, P0.1 was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)

Changing trends in P0.1 during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, P0.1 was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)
PMI
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, PMI was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)

Changing trends in PMI during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, PMI was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)
Pocc
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, Pocc was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)

Changing trends in Pocc during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, Pocc was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h)
Richmond Agitation and Sedation Scale (RASS) score
Prazo: Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, RASS score was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h).

Changing trends in RASS score during remimazolam infusion from 0.15 mg/kg/h to 0.3 mg/kg/h. The RASS scale ranges from -5 to +4. The lower the score, the deeper the level of sedation.

Remimazolam was initiated at 0.15 mg/kg/h and increased it by 0.025 mg/kg/h every 30 minutes, up to a maximum of 0.3 mg/kg/h, RASS score was measured after each infusion rate adjustment (0.15,0.175,0.20,0.225,0.25, 0.275, 0.3mg/kg/h).

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Investigador principal: Jian-Xin Zhou, Capital Medical University

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

10 de maio de 2023

Conclusão Primária (Real)

31 de dezembro de 2024

Conclusão do estudo (Real)

31 de março de 2025

Datas de inscrição no estudo

Enviado pela primeira vez

6 de novembro de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

11 de novembro de 2026

Primeira postagem (Real)

12 de novembro de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

12 de novembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

11 de novembro de 2026

Última verificação

1 de novembro de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • KY2023-182-04

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .