SynthesisIntensive care medicine2013
Optimal sedation in pediatric intensive care patients: a systematic review.
Synthesis 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 trial NCT04684238 (A Randomised Active-controlled Study to Compare Efficacy & Safety of Inhaled Isoflurane Delivered by the AnaConDa-S), which is not on this map. Cited by 60 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 Randomised Active-controlled Study to Compare Efficacy & Safety of Inhaled Isoflurane Delivered by the AnaConDa-S (Anaesthetic Conserving Device) vs IV Midazolam for Sedation in Mechanically Ventilated Paediatric Patients 3-17 Years Old
Who cites it
60 citing papers in PubMed, 3 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Impact of Nurse-Driven Analgesia and Sedation Protocols on Medication Exposure and Withdrawal in Critically Ill Children: A Systematic Review.Nursing in critical care · 2025Pooled it
- Pooled it
- Optimal sedation in pediatric intensive care patients: a systematic review.Intensive care medicine · 2013Pooled it
- Pupillometry for pain assessment in noncommunicating children in the pediatric intensive care unit: a prospective accuracy study.European journal of pediatrics · 2026Trial
- Sedative and Analgesic Drug Rotation Protocol Versus Non-Rotation Protocol in Mechanically Ventilated Children: A Randomised Controlled Trial.Indian journal of pediatrics · 2025Trial
- Sedation Management for Critically Ill Children with Pre-Existing Cognitive Impairment.The Journal of pediatrics · 2019Trial
- A randomized controlled trial of daily sedation interruption in critically ill children.Intensive care medicine · 2016Trial
- Trial
- Adapting Evidence-Based Practice Guidelines for Sedation, Analgesia, Withdrawal, and Delirium Assessment and Management in Critically Ill Children.Critical care research and practice · 2026Article
- ComparativeFrontiers in pediatrics · 2026Article
- Management of arterial hypotension in critically Ill children: a narrative review and practical approach.Frontiers in pediatrics · 2026Review
- Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis.Clinical and experimental pediatrics · 2025Article
- Personalizing ICU liberation for critically Ill children: shaping the future of the ABCDEF bundle.Current opinion in pediatrics · 2025Review
- Safe Sedation and Analgesia Management With Remifentanil in Pediatric ICU Patients: A Report of Two Cases.Cureus · 2025Article
- Translation and psychometric properties of the comfort behavioral scale-Persian version.BMC nursing · 2024Article
- Pediatric patients on veno-arterial extracorporeal membrane oxygenation undergoing cardiac rehabilitation have better outcomes.JHLT open · 2024Article
- Exposure to Sedation and Analgesia Medications: Short-term Cognitive Outcomes in Pediatric Critical Care Survivors With Acquired Brain Injury.Journal of intensive care medicine · 2024Article
- The Ideal Extubation Readiness Testing for the Pediatric Patient: Is There One?Respiratory care · 2023Article
- Effectiveness, quality and implementation of pain, sedation, delirium, and iatrogenic withdrawal syndrome algorithms in pediatric intensive care: a systematic review and meta-analysis.Frontiers in pediatrics · 2023Review
- Comment on "Continuous clonidine infusion: an alternative for children on mechanical ventilation".Revista da Associacao Medica Brasileira (1992) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSedatives administered to critically ill children should be titrated to effect, because both under- and oversedation may have negative effects. We conducted a systematic review to examine reported incidences of under-, optimal, and oversedation in critically ill children receiving intensive care.
methodsA systematic literature search using predefined criteria was performed in PubMed and Embase to identify all articles evaluating level of sedation in PICU patients receiving continuous sedation. Two authors independently recorded: study objective, study design, sample size, age range, details of study intervention (if applicable), sedatives used, length of sedation, sedation scale used, and incidences of optimal, under-, and oversedation as defined in the studies.
resultsTwenty-five studies were included. Two studies evaluated sedation level as primary study outcome; the other 23 as secondary outcomes. Together, these studies investigated 1,163 children; age range, 0-18 years. Across studies, children received many different sedative agents and sedation level was assessed with 12 different sedation scales. Optimal sedation was ascertained in 57.6 % of the observations, under sedation in 10.6 %, and oversedation in 31.8 %.
conclusionsThis study suggests that sedation in the PICU is often suboptimal and seldom systematically evaluated. Oversedation is more common than undersedation. As oversedation may lead to longer hospitalization, tolerance, and withdrawal, preventing oversedation in pediatric intensive care deserves greater attention.
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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.