Trial reportIntensive care medicine2009
Remifentanil-propofol analgo-sedation shortens duration of ventilation and length of ICU stay compared to a conventional regimen: a centre randomised, cross-over, open-label study in the Netherlands.
Trial report in Intensive care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 4 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- Iatrogenic withdrawal syndrome in adult intensive care unit: a scoping review.Frontiers in medicine · 2025Pooled it
- ICU patients receiving remifentanil do not experience reduced duration of mechanical ventilation: a systematic review of randomized controlled trials and network meta-analyses based on Bayesian theories.Frontiers in medicine · 2024Pooled it
- Comparison between remifentanil and other opioids in adult critically ill patients: A systematic review and meta-analysis.Medicine · 2021Pooled it
- Could remifentanil reduce duration of mechanical ventilation in comparison with other opioids for mechanically ventilated patients? A systematic review and meta-analysis.Critical care (London, England) · 2017Pooled it
- Short-term light sedation with remimazolam besylate versus propofol in the ICU (SHOSREB): a multicentre, randomized, single-blind, controlled trial.Intensive care medicine · 2026Trial
- The influence of analgesic-based sedation protocols on delirium and outcomes in critically ill patients: A randomized controlled trial.PloS one · 2017Trial
- Replacement of fentanyl infusion by enteral methadone decreases the weaning time from mechanical ventilation: a randomized controlled trial.Critical care (London, England) · 2012Trial
- Propofol and remifentanil versus midazolam and fentanyl for sedation during therapeutic hypothermia after cardiac arrest: a randomised trial.Intensive care medicine · 2012Trial
- Long-term sedation in intensive care unit: a randomized comparison between inhaled sevoflurane and intravenous propofol or midazolam.Intensive care medicine · 2011Trial
- A prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients.Intensive care medicine · 2011Trial
- Cost-consequence analysis of remifentanil-based analgo-sedation vs. conventional analgesia and sedation for patients on mechanical ventilation in the Netherlands.Critical care (London, England) · 2010Trial
- The cost analysis of remifentanil and fentanyl for analgosedation in mechanically ventilated patients in intensive care: Post hoc analysis of an open-labelled pilot randomised controlled study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Association between opioid infusion use and duration of mechanical ventilation and related outcomes in critically ill adults: a systematic review and meta-analysis.Annals of intensive care · 2026Article
- Efficacy, safety, and pharmacokinetics of MR13A11A, a generic of remifentanil, for pain management of Japanese patients in the intensive care unit: a double-blinded, fentanyl-controlled, randomized, non-inferiority phase 3 study.Journal of intensive care · 2023Article
- Deep Sedation in Traumatic Brain Injury Patients.Korean journal of neurotrauma · 2023Review
- Prevalence and Risk Factors for Iatrogenic Opioid Withdrawal in Medical Critical Care Patients.Critical care explorations · 2023Article
- Comparison of Quantium Consciousness Index and Richmond Agitation Sedation Scale in Mechanically Ventilated Critically Ill Patients: An Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Associations of Fentanyl, Sufentanil, and Remifentanil With Length of Stay and Mortality Among Mechanically Ventilated Patients: A Registry-Based Cohort Study.Frontiers in pharmacology · 2022Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).Journal of intensive care · 2021Article
- Adult sedation and analgesia in a resource limited intensive care unit - A Systematic Review and evidence based guideline.Annals of medicine and surgery (2012) · 2021Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCompare duration of mechanical ventilation (MV), weaning time, ICU-LOS (ICU-LOS), efficacy and safety of remifentanil-based regimen with conventional sedation and analgesia.
designCentre randomised, open-label, crossover, 'real-life' study.
setting15 Dutch hospitals. PATIENTS: Adult medical and post-surgical ICU patients with anticipated short-term (2-3 days) MV.
interventionsPatient cohorts were randomised to remifentanil-based regimen (n = 96) with propofol as required, for a maximum of 10 days, or to conventional regimens (n = 109) of propofol, midazolam or lorazepam combined with fentanyl or morphine. MEASUREMENTS AND MAIN
resultsOutcomes were weaning time, duration of MV, ICU-LOS, sedation- and analgesia levels, intensivist/ICU nurse satisfaction, adverse events, mean arterial pressure, heart rate. Median duration of ventilation (MV) was 5.1 days with conventional treatment versus 3.9 days with remifentanil (NS). The remifentanil-based regimen reduced median weaning time by 18.9 h (P = 0.0001). Median ICU-LOS was 7.9 days versus 5.9 days, respectively (NS). However, the treatment effects on duration of MV and ICU stay were time-dependent: patients were almost twice as likely to be extubated (P = 0.018) and discharged from the ICU (P = 0.05) on day 1-3. Propofol doses were reduced by 20% (P = 0.05). Remifentanil also improved sedation-agitation scores (P < 0.0001) and intensivist/ICU nurse satisfaction (P < 0.0001). All other outcomes were comparable.
conclusionsIn patients with an expected short-term duration of MV, remifentanil significantly improves sedation and agitation levels and reduces weaning time. This contributes to a shorter duration of MV and ICU-LOS.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.