SynthesisMedicine2017
Volatile sedation in the intensive care unit: A systematic review and meta-analysis.
Synthesis in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04839536 (A Comparative Study of Sevoflurane Sedation With TCI Propofol Sedation in Dialysis Dependent End Stage Renal Failure Patients for Transposition of Brachiocephalic Fistula Repair), which is not on this map. Cited by 29 papers, 2 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 Comparative Study of Sevoflurane Sedation With TCI Propofol Sedation in Dialysis Dependent End Stage Renal Failure Patients for Transposition of Brachiocephalic Fistula Repair
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Volatile sedation in critically ill adults undergoing mechanical ventilation: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2025Pooled it
- Renal safety of critical care sedation with sevoflurane: a systematic review and meta-analysis.Journal of anesthesia · 2023Pooled it
- Volatile versus propofol sedation after cardiac valve surgery: a single-center prospective randomized controlled trial.Critical care (London, England) · 2024Trial
- Brief, Repeated Isoflurane Anaesthesia Elicits Sex-Dependent Behavioural, Cerebrovascular and Microglial Alterations in Mice.The European journal of neuroscience · 2026Article
- Lung protective characteristics of volatile anesthetic sedation.Critical care (London, England) · 2026Review
- Critical Care Sedation: Emerging Clinical Considerations and Risks of Volatile Anesthetics for Sedation: A Narrative Review.Diseases (Basel, Switzerland) · 2026Review
- Inhaled sevoflurane in critically ill COVID-19 patients: A retrospective cohort study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- Costs and Arising Work Times of Volatile Short-Term Sedation in Intensive Care.Healthcare (Basel, Switzerland) · 2025Article
- Safety and Satisfaction Analysis of Intravenous and Inhalational Conscious Sedation in a Geriatric Population Undergoing Oral Surgery.Healthcare (Basel, Switzerland) · 2025Article
- Inhaled Anesthetics: Beyond the Operating Room.Journal of clinical medicine · 2024Review
- Sedaconda ACD-S for Sedation with Volatile Anaesthetics in Intensive Care: A NICE Medical Technologies Guidance.Applied health economics and health policy · 2024Review
- Inhaled volatile anesthetics in the intensive care unit.World journal of critical care medicine · 2024Review
- Propofol Affords No Protection against Delayed Cerebral Ischemia in a Mouse Model of Subarachnoid Hemorrhage.Diseases (Basel, Switzerland) · 2023Article
- A Commentary on the Effect of Targeted Temperature Management in Patients Resuscitated from Cardiac Arrest.Therapeutic hypothermia and temperature management · 2023Article
- Sedation with Sevoflurane versus Propofol in COVID-19 Patients with Acute Respiratory Distress Syndrome: Results from a Randomized Clinical Trial.Journal of personalized medicine · 2023Article
- Sedation with volatile anesthetics in the intensive care unit: a new option with old agents.Critical care science · 2023Article
- Inhaled Sedation with Volatile Anesthetics for Mechanically Ventilated Patients in Intensive Care Units: A Narrative Review.Journal of clinical medicine · 2023Review
- Balanced volatile sedation with isoflurane in critically ill patients with aneurysmal subarachnoid hemorrhage - a retrospective observational study.Frontiers in neurology · 2023Article
- Inhaled Sedation in Patients with COVID-19-Related Acute Respiratory Distress Syndrome: An International Retrospective Study.Journal of clinical medicine · 2022Article
- Review of remimazolam and sedatives in the intensive care unit.Acute and critical care · 2022Article
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 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVolatile sedation in the intensive care unit (ICU) may reduce the number of adverse events and improve patient outcomes compared with intravenous (IV) sedation. We performed a systematic review and meta-analysis comparing the effects of volatile and IV sedation in adult ICU patients.
methodsWe searched the PubMed, Embase, Cochrane Central Register, and Web of Science databases for all randomized trials comparing volatile sedation using an anesthetic-conserving device (ACD) with IV sedation in terms of awakening and extubation times, lengths of ICU and hospital stay, and pharmacologic end-organ effects.
resultsThirteen trials with a total of 1027 patients were included. Volatile sedation (sevoflurane or isoflurane) administered through an ACD shortened the awakening time [mean difference (MD), -80.0 minutes; 95% confidence intervals (95% CIs), -134.5 to -25.6; P = .004] and extubation time (MD, -196.0 minutes; 95% CIs, -305.2 to -86.8; P < .001) compared with IV sedation (midazolam or propofol). No differences in the lengths of ICU and hospital stay were noted between the 2 groups. In the analysis of cardiac effects of sedation from 5 studies, patients who received volatile sedation showed lower serum troponin levels 6 hours after ICU admission than patients who received IV sedation (P < .05). The effect size of troponin was largest between 12 and 24 hours after ICU admission (MD, -0.27 μg/L; 95% CIs, -0.44 to -0.09; P = .003).
conclusionCompared with IV sedation, volatile sedation administered through an ACD in the ICU shortened the awakening and extubation times. Considering the difference in serum troponin levels between both arms, volatile anesthetics might have a myocardial protective effect after cardiac surgery even at a subanesthetic dose. Because the included studies used small sample sizes with high heterogeneity, further large, high-quality prospective clinical trials are needed to confirm our findings.
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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.