(1454) Cipepofol Versus Dexmedetomidine for Long-Term Sedation in ICU: A Multicenter Randomised Study

Sunday, February 23, 2025

9:45am – 10:45am Eastern Time

Location: Connections Central - RST 10

First Author(s)

WL

Wanyi Li, MD

CHN

Co-Author(s)

MZ

Minghui Zhu, MD

consultant
Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China, United States
DY

Dong Yuan, MD

consultant
Department of Critical Care Medicine, The first people’s hospital of Changzhou Jintan, Changzhou, China, China (People's Republic)
WX

Wenbo Xu, MD

attending
Department of Critical Care Medicine, The first people’s hospital of Changzhou Jintan, Changzhou, China, China (People's Republic)
WC

Weiyan Cui, MD

consultant
Department of Critical Care Medicine, Changzhou Wujin People’s Hospital, Changzhou, China, China (People's Republic)
HL

Hong Li, MD

consultant
Department of Critical Care Medicine, Chinese Medical Hospital of Wujin, Changzhou, China, China (People's Republic)
FX

Feng Xue, MD

consultant
Department of Critical Care Medicine, Changzhou Third People’s Hospital, Changzhou, China, China (People's Republic)
ZJ

Zhaoquan Jin, MD

associate consultant
Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China, China (People's Republic)
CC

Chuan Chen, MD

attending
Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China, China (People's Republic)
BY

Bo Yang, MD

attending
Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China, China (People's Republic)
MS

Mingfen Sun, MD

attending
Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China, China (People's Republic)
FH

Fan Huang, MD

attending
Department of Critical Care Medicine, Changzhou Wujin People’s Hospital, Changzhou, China, China (People's Republic)
DZ

Dan Zhou, MD

attending
Department of Critical Care Medicine, Chinese Medical Hospital of Wujin, Changzhou, China, China (People's Republic)
YX

Yao Xu, MD

attending
Department of Critical Care Medicine, Changzhou Third People’s Hospital, Changzhou, China, China (People's Republic)
DW

Daming Wang, MD

consultant
Department of Emergency, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China, United States

Introduction: Current sedatives exhibit various side effects during long-term use. Cipepofol, a new sedative similar to propofol, may offer distinct advantages for prolonged sedation. This study aimed to evaluate the efficacy and safety of cipepofol compared to dexmedetomidine in critically ill, mechanically ventilated patients.

Methods: In this multicentered randomized study, adult patients mechanically ventilated longer than 24 h were randomized to receive cipepofol or dexmedetomidine. The target sedation range was +1 to –2 on the Richmond Agitation and Sedation Scale (RASS). The primary outcome were the percentage of time in the target sedation range, the incidence of bradycardia and hypotension, and their durations. The secondary outcomes were the mean time to sedation, recovery time, successful sedation rate without rescue sedation, early sedation success rates within 30 minutes and 1 hour of administration, incidence of adverse events (including hypertension, tachycardia, and agitation), dose adjustments, ventilator-free days at day 28, and 28-day mortality.

Results: Total 142 patients were enrolled. The mean sedation compliance rates were higher in the cipepofol group compared to the dexmedetomidine group (92.18% vs. 87.47%, P = 0.041). Additionally, the mean time to sedation was significantly longer in the cipepofol group (55.31 minutes vs. 52.48 minutes, P = 0.043). Notably, patients treated with cipepofol experienced earlier recovery (0.18 h vs. 0.72 h, P = 0.020) and were less likely to develop bradycardia (16.22% vs. 32.35%, P = 0.040). Cipepofol-treated patients also had higher early sedation success rates within 30 minutes of administration (90.54% vs. 75.00%, P = 0.025) and a greater overall successful sedation rate (50.00% vs. 85.14%, P ＜ 0.001). However, there were no significant differences between the groups in the occurrence rates of hypotension or the remaining secondary endpoints (P > 0.05).

Conclusions: Among mechanically ventilated adults undergoing long-term sedation, cipepofol-treated patients experienced higher mean sedation compliance rates, and developed less bradycardia.