Observational studyChest2017
Analgosedation Practices and the Impact of Sedation Depth on Clinical Outcomes Among Patients Requiring Mechanical Ventilation in the ED: A Cohort Study.
Observational study in Chest, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 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
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Different depths of sedation versus risk of delirium in adult mechanically ventilated patients: A systematic review and meta-analysis.PloS one · 2020Pooled it
- Practice Patterns and Outcomes Associated With Early Sedation Depth in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis.Critical care medicine · 2018Pooled it
- Choice of initial opioid for continuous infusions in patients receiving mechanical ventilation: a retrospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- Administration of Post-intubation Analgesia and Sedation in Injured Patients in New Brunswick EDs.Cureus · 2026Article
- Post-intubation sedation in the emergency department: A scoping review.The American journal of emergency medicine · 2026Article
- Sedation practices in patients intubated in the emergency department compared with those in patients in the intensive care unit.Critical care science · 2025Article
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- Article
- The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea.Journal of Korean medical science · 2023Article
- Management of Coronavirus Disease-2019 Infection in Pregnancy.Emergency medicine clinics of North America · 2023Review
- A dual-center cohort study on the association between early deep sedation and clinical outcomes in mechanically ventilated patients during the COVID-19 pandemic: The COVID-SED study.Critical care (London, England) · 2022Article
- A Dual-Center Cohort Study on The Association Between Early Deep Sedation and Clinical Outcomes in Mechanically Ventilated Patients During the COVID-19 Pandemic: the COVID-SED Study.Research square · 2022Article
- The AIR-SED Study: A Multicenter Cohort Study of SEDation Practices, Deep Sedation, and Coma Among Mechanically Ventilated AIR Transport Patients.Critical care explorations · 2021Article
- Variability in sedation assessment among intubated patients in the emergency department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- Quality Improvement Initiative to Increase Rate of and Time to Post-intubation Analgesia in the Emergency Department.The western journal of emergency medicine · 2021Article
- The ED-AWARENESS Study: A Prospective, Observational Cohort Study of Awareness With Paralysis in Mechanically Ventilated Patients Admitted From the Emergency Department.Annals of emergency medicine · 2021Observational
- Article
- Inpatient hospital performance is associated with post-discharge sepsis mortality.Critical care (London, England) · 2020Article
- Managing sedation in the mechanically ventilated emergency department patient: a clinical review.Journal of the American College of Emergency Physicians open · 2020Review
- The ED-SED Study: A Multicenter, Prospective Cohort Study of Practice Patterns and Clinical Outcomes Associated With Emergency Department SEDation for Mechanically Ventilated Patients.Critical care medicine · 2019Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundAnalgesia and sedation are cornerstone therapies for mechanically ventilated patients. Despite data showing that early deep sedation in the ICU influences outcome, this has not been investigated in the ED. Therefore, ED-based sedation practices, and their influence on outcome, remain incompletely defined. This study's objectives were to describe ED sedation practices in mechanically ventilated patients and to test the hypothesis that ED sedation depth is associated with worse outcomes.
methodsThis was a cohort study of a prospectively compiled ED registry of adult mechanically ventilated patients at a single academic medical center. Hospital mortality was the primary outcome and hospital-, ICU-, and ventilator-free days were secondary outcomes. A backward stepwise multivariable logistic regression model evaluated the primary outcome as a function of ED sedation depth. Sedation depth was assessed with the Richmond Agitation-Sedation Scale (RASS).
resultsFour hundred fourteen patients were studied. In the ED, 354 patients (85.5%) received fentanyl, 254 (61.3%) received midazolam, and 194 (46.9%) received propofol. Deep sedation was observed in 244 patients (64.0%). After adjusting for confounders, a deeper ED RASS was associated with mortality (adjusted OR, 0.77; 95% CI, 0.63-0.94).
conclusionsEarly deep sedation is common in mechanically ventilated ED patients and is associated with worse mortality. These data suggest that ED-based sedation is a modifiable variable that could be targeted to improve outcome.
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