SynthesisCritical care medicine2018
Practice Patterns and Outcomes Associated With Early Sedation Depth in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis.
Synthesis in Critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07580781 (Feasibility of a Cluster Randomised Control Trial Evaluating a Co-designed Analgosedation Protocol in Extracorporeal Membrane Oxygenation), which is not on this map. Cited by 79 papers, 4 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.
Feasibility of a Cluster Randomised Control Trial Evaluating a Co-designed Analgosedation Protocol in Extracorporeal Membrane Oxygenation (ECMO) Patients
Who cites it
79 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Comparison of clinical effectiveness of conbercept and ranibizumab for treating retinopathy of prematurity: a meta-analysis.International journal of clinical pharmacy · 2023Pooled it
- Non-Pharmacological Interventions for Minimizing Physical Restraints Use in Intensive Care Units: An Umbrella Review.Frontiers in medicine · 2022Pooled it
- Neuromuscular blocking agents for acute respiratory distress syndrome: an updated meta-analysis of randomized controlled trials.Respiratory research · 2020Pooled it
- Different depths of sedation versus risk of delirium in adult mechanically ventilated patients: A systematic review and meta-analysis.PloS one · 2020Pooled it
- A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Trial
- Exploring Relations Between Unique Patient Characteristics and Virtual Reality Immersion Level on Anxiety and Pain in Patients Undergoing Venipuncture: Secondary Analysis of a Randomized Control Trial.Journal of medical Internet research · 2024Trial
- Ethnic Disparities in Deep Sedation of Patients with Acute Respiratory Distress Syndrome in the United States: Secondary Analysis of a Multicenter Randomized Trial.Annals of the American Thoracic Society · 2024Trial
- Trial
- Early mobilization for mechanical ventilation for sepsis or acute respiratory failure (EVER): a multicenter randomized controlled trial with 12-month outcomes.Intensive care medicine · 2026Article
- Accuracy and Documentation of Richmond Agitation-Sedation Scale Assessments in a Cardiothoracic Critical Care Unit: A Prospective, Cross-Sectional Audit.Nursing in critical care · 2026Article
- Early Versus Late Wake-Up Call After Out-Of-Hospital Cardiac Arrest: Protocol for a Multicenter Randomized Comparison Within the Danish Out-of-Hospital Cardiac Arrest (DANOHCA) Trial.Acta anaesthesiologica Scandinavica · 2026Article
- Depth of anesthesia monitoring: Current evidence, clinical impact, and future directions.The Journal of international medical research · 2026Review
- Early Sedation Intensity and Psychological Outcomes in Critically Ill Adults.Nursing in critical care · 2026Article
- Development and Psychometric Testing of the Optimizing Context in Assessing Sedation in ICU (OCEAN-ICU) Instrument to Optimize Sedation Use in Intensive Care.Critical care explorations · 2026Article
- Saudi Guideline for Mechanical Ventilation in Adults.Saudi journal of medicine & medical sciences · 2026Article
- Management of Mechanical Ventilation in Emergency Medicine: A Scoping Review.Journal of the American College of Emergency Physicians open · 2026Review
- Post-intubation sedation in the emergency department: A scoping review.The American journal of emergency medicine · 2026Article
- Barriers and facilitators to the delivery of delirium care in intensive care units: an analysis informed by the Theoretical Domains Framework.Anaesthesia · 2026Article
- Sedation level variability an indicator for mortality in mechanical ventilated critically ill patients: a propensity score-weighted cohort study.Frontiers in medicine · 2026Article
- Machine learning-driven sedation-analgesia optimization in mechanically ventilated sepsis patients: a retrospective MIMIC-IV analysis.Frontiers in pharmacology · 2026Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
7 authors.
Funding
Abstract
objectivesEmerging data suggest that early deep sedation may negatively impact clinical outcomes. This systematic review and meta-analysis defines and quantifies the impact of deep sedation within 48 hours of initiation of mechanical ventilation, as described in the world's literature. The primary outcome was mortality. Secondary outcomes included hospital and ICU lengths of stay, mechanical ventilation duration, and delirium and tracheostomy frequency. DATA SOURCES: The following data sources were searched: MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews and Effects, Cochrane Database of Systematic Reviews databases, ClinicalTrials.gov, conference proceedings, and reference lists. STUDY SELECTION: Randomized controlled trials and nonrandomized studies were included. DATA EXTRACTION: Two reviewers independently screened abstracts of identified studies for eligibility. DATA SYNTHESIS: Nine studies (n = 4,521 patients) published between 2012 and 2017 were included. A random effects meta-analytic model revealed that early light sedation was associated with lower mortality (9.2%) versus deep sedation (27.6%) (odds ratio, 0.34 [0.21-0.54]). Light sedation was associated with fewer mechanical ventilation (mean difference, -2.1; 95% CI, -3.6 to -0.5) and ICU days (mean difference, -3.0 (95% CI, -5.4 to -0.6). Delirium frequency was 28.7% in the light sedation group and 48.5% in the deep sedation group, odds ratio, 0.50 (0.22-1.16).
conclusionsDeep sedation in mechanically ventilated patients, as evaluated in a small number of qualifying heterogeneous randomized controlled trials and observational studies, was associated with increased mortality and lengths of stay. Interventions targeting early sedation depth assessment, starting in the emergency department and subsequent ICU admission, deserve further investigation and could improve outcome.
Indexed as
Identifiers
What OpenQuestion holds
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.