Observational studyJournal of critical care2018
Association between death and loss of stage N2 sleep features among critically Ill patients with delirium.
Observational study in Journal of critical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06468436 (Effect of Dexmedetomidine-Esketamine Combination for Sedation and Analgesia on Delirium in ICU Patients With Mechanical Ventilation), which is not on this map. Cited by 19 papers.
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.
Effect of Dexmedetomidine-Esketamine Combination for Sedation and Analgesia on Delirium in ICU Patients With Mechanical Ventilation: A Multicenter Randomized Trial
Who cites it
19 citing papers in PubMed, 57 citations in OpenAlex.
- EEG spindles integrity in critical care adults. Analysis of a randomized trial.Acta neurologica Scandinavica · 2021Trial
- Sleep interruption aggravates sepsis by rewiring the macrophage immune response.Journal of immunology (Baltimore, Md. : 1950) · 2026Article
- Dexmedetomidine improves sleep quality and alleviates emotional dysfunction by attenuating α-synuclein deposition in mice with sepsis-associated encephalopathy.Journal of advanced research · 2026Article
- Improving sleep in ICUs through real-time sleep monitoring: a proof-of-concept study.Annals of intensive care · 2026Article
- Wearable devices for patient monitoring in the intensive care unit.Intensive care medicine experimental · 2025Review
- Sleep fragmentation in critically ill children: a review of contributing factors in the pediatric intensive care unit and neurodevelopmental outcomes.Frontiers in sleep · 2025Review
- Correlation Between Sleep Continuity and Patient-Reported Sleep Quality in Conscious Critically Ill Patients at High Risk of Reintubation: A Pilot Study.Critical care explorations · 2023Article
- The phenotype of delirium based on a close reading of diagnostic criteria.International journal of geriatric psychiatry · 2023Review
- Admission Clinical and EEG Features Associated With Mortality and Long-term Neurologic and Cognitive Outcomes in Pediatric Cerebral Malaria.Neurology · 2023Article
- Sleep during and following critical illness: A narrative review.World journal of critical care medicine · 2023Review
- Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2023Article
- Sleep and critical illness: a review.Frontiers in medicine · 2023Review
- Monitoring of nighttime EEG slow-wave activity during dexmedetomidine infusion in patients with hyperactive ICU delirium: An observational pilot study.Acta anaesthesiologica Scandinavica · 2022Observational
- Adding Insult to Injury: Sleep Deficiency in Hospitalized Patients.Clinics in chest medicine · 2022Review
- Electroencephalography in delirium assessment: a scoping review.BMC neurology · 2022Article
- Sleep Assessment in Critically Ill Adults: Established Methods and Emerging Strategies.Critical care explorations · 2022Review
- Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: a prospective observational study.BMC pulmonary medicine · 2021Observational
- Pilot Observational Study to Detect Diurnal Variation and Misalignment in Heart Rate Among Critically Ill Patients.Frontiers in neurology · 2020Article
- Sleep, circadian rhythms and outcomes in intensive care unit.Frontiers in neurologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
purposeCritically ill patients experience significant sleep disruption. In this study of ICU patients with delirium, we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death. MATERIALS AND
methodsThis was an observational cohort study of 93 medical ICU patients without primary acute brain injury who underwent continuous EEG. Type and severity of critical illness, sedative-hypnotic use, length of stay, modified Rankin Scale at hospital discharge, and death during hospitalization were abstracted from the medical record. EEG was evaluated for grade of encephalopathy and sleep features.
resultsPatients without K-complexes or without sleep spindles had more severe encephalopathy and higher odds of death. The odds ratio for patients without K-complexes was 18.8 (p = .046). The odds ratio for patients without sleep spindles was 6.3 (p = .036).
conclusionsLoss of stage N2 features is common and associated with more severe encephalopathy and higher odds of death. The absence of either Stage N2 feature, K complexes or sleep spindles, may have important prognostic value.
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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.