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

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

Remifentanil, Delirium, Critical illness

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 inten-
sive care unit (ICU) patients requiring ventilatory management would improve delirium outcomes. This retrospec-
tive 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.
Keywords Remifentanil, Delirium, Critical illness

Junpei Haruna1

, Aki Sasaki2 and Satoshi Kazuma1*

https://doi.org/10.1186/s12245-025-00846-y

2025

Peri Irawan

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