PK/PD Properties and Safety of Remazolam Besylate for Injection in ICU Patients With Impaired Renal Function

Inclusion Criteria: * Age ≥18 and ≤80 years, regardless of gender; * Anticipated requirement for mechanical ventilation and sedation ≥24 hours; * arget sedation level within RASS score range of -3 to 0 (inclusive); Patients with renal impairment were defined as having a glomerular filtration rate (GFR) \<90 mL/min/1.73m². Patients with normal renal function were defined as having a glomerular filtration rate of 90 to 120 ml/min/1.73m2 Exclusion Criteria: * BMI\<18 or \>30kg/m2; * Hypersensitivity to study drugs/opioids/reversal agents; * Life expectancy \<48 hours; * Scheduled surgery requiring general anesthesia within 24h; * Myasthenia gravis; * Moderate-severe hepatic impairment (Child-Pugh ≥B); * Severe CKD (eGFR \<30 mL/min/1.73m²) or renal replacement therapy within 3 days; * Recent benzodiazepine use (≤1 week) or chronic benzodiazepine dependence; * Hemodynamic instability (≥2 vasopressors to maintain SBP \>90 mmHg); * Inability to perform RASS assessment (e.g., major neuropsychiatric disorders, coma); * Pregnancy/lactation; * Acute coronary syndrome or severe cardiac dysfunction (LVEF ≤30%, advanced heart block, HR\<50 bpm without pacing); * Active ECMO/IABP support; Substance abuse history (≤2 years)。