Trial reportIntensive care medicine2013
Automated sedation outperforms manual administration of propofol and remifentanil in critically ill patients with deep sedation: a randomized phase II trial.
Trial report in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 18 papers, 1 of them a synthesis 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.
Postoperative Sedation After Cardiac Surgery: Pilot Study
Performance Assessment of the PMD-200 in Subjects Requiring Surgery Under General Anesthesia
Postoperative Sedation After Cardiac Surgery : Comparison Between Manual Administration and Automated Sedation
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Comparison between remifentanil and other opioids in adult critically ill patients: A systematic review and meta-analysis.Medicine · 2021Pooled it
- Fospropofol disodium versus Propofol for deep sedation in critically ill patients: a randomized pilot study.BMC anesthesiology · 2025Trial
- Remimazolam besylate versus propofol for deep sedation in critically ill patients: a randomized pilot study.Critical care (London, England) · 2023Trial
- Automated titration of propofol and remifentanil decreases the anesthesiologist's workload during vascular or thoracic surgery: a randomized prospective study.Journal of clinical monitoring and computing · 2014Trial
- Target-controlled infusion for analgesia and sedation in the intensive care unit: a scoping review.Annals of intensive care · 2026Review
- Pharmacotherapeutic Controversies During Temperature Control After Out-of-Hospital Cardiac Arrest: A Semi-Structured Literature Review.Pharmacotherapy · 2026Review
- Safe automation of interfering medical treatments via control barrier functions and reachability analysis: a fluid resuscitation-sedation-vasopressor infusion case study.Journal of clinical monitoring and computing · 2025Article
- Closed-loop anesthesia: foundations and applications in contemporary perioperative medicine.Journal of clinical monitoring and computing · 2024Review
- Efficacy of Remifentanil in Patients Undergoing Cardiac Surgery: A Systematic Review and Network Meta-Analysis.Cureus · 2023Review
- Rationale and design of a randomized controlled clinical trial; Titration of Oxygen Levels (TOOL) during mechanical ventilation.Contemporary clinical trials · 2022Article
- Machine Learning, Deep Learning, and Closed Loop Devices-Anesthesia Delivery.Anesthesiology clinics · 2021Review
- Analgesia and sedation in patients with ARDS.Intensive care medicine · 2020Review
- Behavior of a dual closed-loop controller of propofol and remifentanil guided by the bispectral index for postoperative sedation of adult cardiac surgery patients: a preliminary open study.Journal of clinical monitoring and computing · 2020Article
- Pain and Physical Activity Association in Critically Ill PatientsAnnual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2020Article
- Fully automated life support: an implementation and feasibility pilot study in healthy pigs.Intensive care medicine experimental · 2018Article
- Automation of anaesthesia: a review on multivariable control.Journal of clinical monitoring and computing · 2015Review
- Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients.Intensive care medicine · 2014Article
- Physicians declining patient enrollment in clinical trials: what are the implications?Intensive care medicine · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo compare automated administration of propofol and remifentanil guided by the Bispectral index (BIS) versus manual administration of short-acting drugs in critical care patients requiring deep sedation. The primary outcome was the percentage of BIS values between 40 and 60 (BIS(40-60)).
methodsThis randomized controlled phase II trial in the intensive care unit (ICU) was conducted in adults with multiorgan failure. Thirty-one patients were assigned to receive sedation with propofol or remifentanil either by an automated or a manual system, both targeting BIS(40-60). Performance and feasibility of an automated administration were assessed.
resultsThe study groups were well balanced in terms of demographic characteristics. Study duration averaged 18 [8-24] h in the automated group and 14 [9-21] h in the manual group (p = 0.81). Adequate sedation (BIS(40-60)) was significantly more frequent in the automated group 77 [59-82] % than in the manual group 36 [22-56] %, with p = 0.001. Propofol consumption was reduced by a factor of 2 in the automated group with a median change of infusion rates of 39 ± 9 times per hour. In contrast, there were only 2 ± 1 propofol and 1 ± 1 remifentanil dose changes per hour in the manual group compared to 40 ± 9 for remifentanil in the automated group (p < 0.001). Vasopressors were more often discontinued or reduced in the automated group than in the manual control group (36 [6-40] vs. 12 [4-20] modifications, p = 0.03).
conclusionsContinuous titration of propofol and remifentanil sedation with an automatic controller maintains deep sedation better than manual control in severely ill patients. It is associated with reduced sedative and vasopressor use.
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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.