SynthesisCritical care (London, England)2017
Could remifentanil reduce duration of mechanical ventilation in comparison with other opioids for mechanically ventilated patients? A systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04204967 (Impact of Totally Transdermal Sedation in the Weaning From Remifentanil Infusion Among Critically Ill Patients Undergoing Mechanical Ventilation), which is not on this map. Cited by 21 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.
Impact of Totally Transdermal Sedation in the Weaning From Remifentanil Infusion Among Critically Ill Patients Undergoing Mechanical Ventilation: a Pilot Randomized-controlled Study (The TOES Trial)
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- ICU patients receiving remifentanil do not experience reduced duration of mechanical ventilation: a systematic review of randomized controlled trials and network meta-analyses based on Bayesian theories.Frontiers in medicine · 2024Pooled it
- Effects of fentanyl administration in mechanically ventilated patients in the intensive care unit: a systematic review and meta-analysis.BMC anesthesiology · 2022Pooled it
- Comparison between remifentanil and other opioids in adult critically ill patients: A systematic review and meta-analysis.Medicine · 2021Pooled it
- Neutropenia Potentially Associated With Remifentanil Administered for Respiratory Drive Suppression: A Case Report.Clinical case reports · 2026Article
- 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
- Remifentanil use in critically Ill patients requiring mechanical ventilation is associated with increased delirium-free days: a retrospective study.International journal of emergency medicine · 2025Article
- Remi-fent 1-A pragmatic randomised controlled study to evaluate the feasibility of using remifentanil or fentanyl as sedation adjuncts in mechanically ventilated patients.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Efficacy of Remifentanil in Patients Undergoing Cardiac Surgery: A Systematic Review and Network Meta-Analysis.Cureus · 2023Review
- Comparison of Recovery Effect for Sufentanil vs. Remifentanil Anesthesia in Elderly Patients Undergoing Curative Resection for Hepatocellular Carcinoma.Pain and therapy · 2023Article
- Management of procedural pain in the intensive care unit.World journal of clinical cases · 2022Review
- Associations of Fentanyl, Sufentanil, and Remifentanil With Length of Stay and Mortality Among Mechanically Ventilated Patients: A Registry-Based Cohort Study.Frontiers in pharmacology · 2022Article
- Use of Opioids and Outcomes of Pneumonia: Results From the US Nationwide Inpatient Sample.Journal of acute medicine · 2021Article
- Remifentanil provides an increased proportion of time under light sedation than fentanyl when combined with dexmedetomidine for mechanical ventilation.The Journal of international medical research · 2021Article
- Hemodynamics and anesthetic effect of propofol combined with remifentanil in patients undergoing laparoscopic ovarian cystectomy under laryngeal mask airway anesthesia.American journal of translational research · 2021Article
- Management of critically ill patients with COVID-19 in ICU: statement from front-line intensive care experts in Wuhan, China.Annals of intensive care · 2020Review
- Early prediction of extubation failure in patients with severe pneumonia: a retrospective cohort study.Bioscience reports · 2020Article
- Evolving targets for sedation during mechanical ventilation.Current opinion in critical care · 2020Review
- Effects of sedatives and opioids on trigger and cycling asynchronies throughout mechanical ventilation: an observational study in a large dataset from critically ill patients.Critical care (London, England) · 2019Observational
- Risk factors of frailty and death or only frailty after intensive care in non-frail elderly patients: a prospective non-interventional study.Journal of intensive care · 2019Article
- Remifentanil-induced postoperative hyperalgesia: current perspectives on mechanisms and therapeutic strategies.Local and regional anesthesia · 2018Review
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 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSedation and analgesia are commonly required to relieve anxiety and pain in mechanically ventilated patients. Fentanyl and morphine are the most frequently used opioids. Remifentanil is a selective μ-opioid receptor that is metabolized by unspecific esterases and eliminated independently of liver or renal function. Remifentanil has a rapid onset and offset and a short context-sensitive half-life regardless of the duration of infusion, which may lead to reductions in weaning and extubation. We aimed to compare the efficacy and safety of remifentanil to that of other opioids in mechanically ventilated patients.
methodsWe conducted a search to identify relevant randomized controlled studies (RCTs) in the PubMed, Embase, Cochrane Library and SinoMed databases that had been published up to 31 December 2016. The results were analysed using weighted mean differences (WMDs) and 95% confidence intervals (CIs).
resultsTwenty-three RCTs with 1905 patients were included. Remifentanil was associated with reductions in the duration of mechanical ventilation (mean difference -1.46; 95% CI -2.44 to -0.49), time to extubation after sedation cessation (mean difference -1.02; 95% CI -1.59 to -0.46), and ICU-LOS (mean difference -0.10; 95% CI -0.16 to -0.03). No significant differences were identified in hospital-LOS (mean difference -0.05; 95% CI -0.25 to 0.15), costs (mean difference -709.71; 95% CI -1590.98 to 171.55; I
conclusionsRemifentanil seems to be associated with reductions in the duration of mechanical ventilation, time to extubation after cessation of sedation, and ICU-LOS. No significant differences were identified between remifentanil and other opioids in terms of hospital-LOS, costs, mortality or agitation.
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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.