SynthesisCritical care (London, England)2009
The incidence of sub-optimal sedation in the ICU: a systematic review.
Synthesis in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06203405 (The Efficacy of P0.1-guided Sedation Protocol in Critically Ill Patients Receiving Invasive Mechanical Ventilation), which is not on this map. Cited by 45 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The Efficacy of P0.1-guided Sedation Protocol in Critically Ill Patients Receiving Invasive Mechanical Ventilation: A Randomized Controlled Trial
Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Evaluation of Objective Sedation Monitoring Practices in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis.Critical care explorations · 2025Pooled it
- Protocol-directed sedation versus non-protocol-directed sedation in mechanically ventilated intensive care adults and children.The Cochrane database of systematic reviews · 2018Pooled it
- Effect of Protocolized Sedation on Clinical Outcomes in Mechanically Ventilated Intensive Care Unit Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Mayo Clinic proceedings · 2015Pooled it
- Optimal sedation in pediatric intensive care patients: a systematic review.Intensive care medicine · 2013Pooled it
- Trial
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- Association Between Cumulative Sedative Exposure and ICU Length of Stay Without a Significant Association with Mortality.Life (Basel, Switzerland) · 2026Article
- Strategies for a Rational Use of Opioids in Critical Care Settings.Journal of clinical medicine · 2026Review
- Evaluation of different sedation scales in the ICU management of COVID-19 patients.Scientific reports · 2025Article
- Metal Oxide Nanocatalysts for the Electrochemical Detection of Propofol.Micromachines · 2025Article
- Association of NR1I2 Polymorphism with Midazolam Clearance in Mechanically Ventilated ICU Patients: A Population Pharmacokinetic and Pharmacogenetic Study.Drug design, development and therapy · 2025Article
- Analgesia and sedation increases bronchopulmonary dysplasia risk without significant neurodevelopmental impairment in very preterm infants.Frontiers in medicine · 2025Article
- An automated ICU agitation monitoring system for video streaming using deep learning classification.BMC medical informatics and decision making · 2024Article
- Observational
- The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea.Journal of Korean medical science · 2023Article
- Novel insights on association and reactivity of Bispectral Index, frontal electromyogram, and autonomic responses in nociception-sedation monitoring of critical care patients.BMC anesthesiology · 2022Article
- Article
- Electroencephalogram-Based Evaluation of Impaired Sedation in Patients with Moderate to Severe COVID-19 ARDS.Journal of clinical medicine · 2022Article
- Factors Associated With Deep Sedation Practice in Mechanically Ventilated Patients: AFrontiers in medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
introductionPatients in intensive care units (ICUs) are generally sedated for prolonged periods. Over-sedation and under-sedation both have negative effects on patient safety and resource use. We conducted a systematic review of the literature in order to establish the incidence of sub-optimal sedation (both over- and under-sedation) in ICUs.
methodsWe searched Medline, Embase and CINAHL (Cumulative Index to Nursing and Allied Health Literature) online literature databases from 1988 to 15 May 2008 and hand-searched conferences. English-language studies set in the ICU, in sedated adult humans on mechanical ventilation, which reported the incidence of sub-optimal sedation, were included. All abstracts were reviewed twice by two independent reviewers, with all conflicts resolved by a third reviewer, to check that they met the review inclusion criteria. Full papers of all included studies were retrieved and were again reviewed twice against inclusion criteria. Data were doubly extracted. Study aims, design, population, comparisons made, and data on the incidence of sub-optimal, optimal, over-sedation or under-sedation were extracted.
resultsThere was considerable variation between included studies in the definition of optimal sedation and in the scale or method used to assess sedation. Across all included studies, a substantial incidence of sub-optimal sedation was reported, with a greater tendency toward over-sedation.
conclusionsOur review suggests that improvements in the consistent definition and measurement of sedation may improve the quality of care of patients within the ICU.
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Registered trials
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.