Trial reportCritical care (London, England)2010
Cost-consequence analysis of remifentanil-based analgo-sedation vs. conventional analgesia and sedation for patients on mechanical ventilation in the Netherlands.
Trial report in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 16 papers, 3 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.
A Centre-Randomized, Open-Label, Cross-Over Study to Compare the Pharmaco-Economic Consequences of an Ultiva (Remifentanil Hydrochloride) Based Regimen With Conventional Sedative Based Regimens in ICU Subjects Requiring Short-Term Mechanical Ventilation With Analgesia and Sedation
the Research of Analgesia and Sedation Effect of Remifentanil on ICU Short Operation
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- 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
- Dexmedetomidine versus standard care sedation with propofol or midazolam in intensive care: an economic evaluation.Critical care (London, England) · 2015Pooled it
- Inguinal hernia repair in day surgery: the role of MAC (Monitored Anesthesia Care) with remifentanil.Il Giornale di chirurgiaTrial
- 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
- Article
- Comparative efficacy of remifentanil and fentanyl in mechanically ventilated ICU patients: a systematic review and meta-analysis on ventilation duration and delirium incidence.Journal of anesthesia, analgesia and critical care · 2025Article
- Impact of a remifentanil supply shortage on mechanical ventilation in a tertiary care hospital: a retrospective comparison.Critical care (London, England) · 2018Article
- Emergency Neurological Life Support: Airway, Ventilation, and Sedation.Neurocritical care · 2017Article
- Emergency Neurological Life Support: Airway, Ventilation, and Sedation.Neurocritical care · 2015Review
- Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study.Critical care research and practice · 2015Article
- Article
- Early enteral nutrition in critical illness: a full economic analysis using US costs.ClinicoEconomics and outcomes research : CEOR · 2013Article
- Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a full economic analysis of a multicenter randomized controlled trial based on US costs.ClinicoEconomics and outcomes research : CEOR · 2013Article
- Emergency neurological life support: airway, ventilation, and sedation.Neurocritical care · 2012Review
- Remifentanil use in intensive care units: Current evidence and future perspectives.Acute medicine & surgeryReview
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 at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHospitals are increasingly forced to consider the economics of technology use. We estimated the incremental cost-consequences of remifentanil-based analgo-sedation (RS) vs. conventional analgesia and sedation (CS) in patients requiring mechanical ventilation (MV) in the intensive care unit (ICU), using a modelling approach.
methodsA Markov model was developed to describe patient flow in the ICU. The hourly probabilities to move from one state to another were derived from UltiSAFE, a Dutch clinical study involving ICU patients with an expected MV-time of two to three days requiring analgesia and sedation. Study medication was either: CS (morphine or fentanyl combined with propofol, midazolam or lorazepam) or: RS (remifentanil, combined with propofol when required). Study drug costs were derived from the trial, whereas all other ICU costs were estimated separately in a Dutch micro-costing study. All costs were measured from the hospital perspective (price level of 2006). Patients were followed in the model for 28 days. We also studied the sub-population where weaning had started within 72 hours.
resultsThe average total 28-day costs were €15,626 with RS versus €17,100 with CS, meaning a difference in costs of €1474 (95% CI -2163, 5110). The average length-of-stay (LOS) in the ICU was 7.6 days in the RS group versus 8.5 days in the CS group (difference 1.0, 95% CI -0.7, 2.6), while the average MV time was 5.0 days for RS versus 6.0 days for CS. Similar differences were found in the subgroup analysis.
conclusionsCompared to CS, RS significantly decreases the overall costs in the ICU.
trial registrationClinicaltrials.gov NCT00158873.
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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.