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World J Crit Care Med. Jun 9, 2026; 15(2): 116049
Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.116049
Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.116049
Letter to the Editor: Impact of the intensivist at the bedside - the case of rational use of benzodiazepines
Wagner Nedel, Department of Intensive Care Unit, Conceição Hospital Group, Porto Alegre 91350200, Brazil
Author contributions: Nedel W contributed to manuscript conceptualization and writing.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Wagner Nedel, MD, PhD, Assistant Professor, Department of Intensive Care Unit, Conceição Hospital Group, Francisco Trein 596, Segundo Andar, Porto Alegre 91350200, Brazil. wagnernedel@gmail.com
Received: November 2, 2025
Revised: December 19, 2025
Accepted: January 27, 2026
Published online: June 9, 2026
Processing time: 201 Days and 18.6 Hours
Revised: December 19, 2025
Accepted: January 27, 2026
Published online: June 9, 2026
Processing time: 201 Days and 18.6 Hours
Core Tip
Core Tip: Continuous infusion of benzodiazepines, such as midazolam, is associated with worse outcomes in critically ill patients. This study indicates that management by a dedicated critical care team (CCT) significantly reduces the use of midazolam, thereby reducing the risk of delirium and coma. CCT is especially effective when combined with organizational strengths, such as low patient-to-nurse ratios. Ultimately, a “virtuous circle” of care, in which CCT is an important player, is essential for improving outcomes through precise patient-centered sedo-analgesia.