Association between sedation drugs and delirium in patients undergoing extracorporeal membrane oxygenation: a single-center retrospective study

Background: Delirium is a frequent and serious complication in critically ill patients, particularly those receiving extracorporeal membrane oxygenation (ECMO), and is associated with increased morbidity and mortality. This study aimed to evaluate the association between different sedation drugs and the occurrence of delirium in patients receiving ECMO, as well as to explore other potential risk factors by analyzing baseline characteristics and laboratory findings. Methods: A retrospective cohort study was conducted on patients receiving ECMO who were monitored for delirium. Baseline characteristics, laboratory findings, and the duration and types of sedative drugs used were analyzed to determine their association with delirium. Logistic regression analysis was performed to evaluate the effect of sedatives on delirium risk. Results: Of the 51 patients on ECMO (mean age: 56 years; males: 39), 34 developed delirium, while 17 did not. Significant differences were observed in the use of tracheostomy and sedative drug combinations between groups. Logistic regression revealed that midazolam was associated with a significantly higher risk of delirium (odds ratio: 15.39, 95% confidence interval: 2.14-110.70), whereas sufentanil and dexmedetomidine did not show significant associations. Conclusions: Midazolam use was strongly associated with increased delirium risk in patients on ECMO, whereas sufentanil and dexmedetomidine were not associated with delirium. These findings highlight the importance of sedative management in critically ill patients undergoing ECMO.