SynthesisChest2021
Safety and Efficacy of Dexmedetomidine in Acutely Ill Adults Requiring Noninvasive Ventilation: A Systematic Review and Meta-analysis of Randomized Trials.
Synthesis in Chest, 2021. 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 42 papers, 6 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.
Effect of Dexmedetomidine-Esketamine Combination for Sedation and Analgesia on Delirium in ICU Patients With Mechanical Ventilation: A Multicenter Randomized Trial
Who cites it
42 citing papers in PubMed, 6 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Efficacy and safety of midazolam versus dexmedetomidine in mechanically ventilated intensive care unit patients: a systematic review and meta-analysis.Frontiers in pharmacology · 2026Pooled it
- A systematic meta-review of interventions to prevent and manage delirium in the Intensive Care Unit: Part 1 - Pharmacological interventions.Critical care (London, England) · 2025Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Pooled it
- Dexmedetomidine vs other sedatives in critically ill mechanically ventilated adults: a systematic review and meta-analysis of randomized trials.Intensive care medicine · 2022Pooled it
- Pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysis.Intensive care medicine · 2021Pooled it
- Dexmedetomidine for sedation during noninvasive ventilation in COVID-19 patients from the Helmet-COVID randomized clinical trial post-hoc analysis.Scientific reports · 2026Trial
- Use of Sedation During Non-Invasive Ventilation in Intensive Care Unit: A Systematic Review and Meta-Analysis.Journal of personalized medicine · 2026Review
- Dexmedetomidine in The Treatment of Toxicologic Conditions in The Emergency Department: A Dual-Center Retrospective Observational Cohort Study.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Observational
- Analgosedation During the Use of Non-Invasive Respiratory Supports: A Synthesis of Clinical Evidence and Best Practices.Journal of clinical medicine · 2026Review
- Respiratory Support in Cardiogenic Pulmonary Edema: Clinical Insights from Cardiology and Intensive Care.Journal of cardiovascular development and disease · 2026Review
- Effects of dexmedetomidine on respiratory and hemodynamic changes in patients receiving high-flow nasal cannula: A retrospective observational study.The Journal of international medical research · 2026Observational
- Dexmedetomidine in Palestinian intensive care units: The first multicenter cross-sector survey of sedation practices, protocol gaps, and withdrawal challenges.SAGE open medicine · 2026Article
- Evaluation of Dexmedetomidine-Associated Bradycardia and Related Drug-Drug Interactions Using Electronic Health Record (EHR) and miRNA Target Analysis.Current issues in molecular biology · 2025Article
- Dexmedetomidine's Role in Adult ICU After 20 Years of Experience-A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Use of sedation for adults admitted to the intensive care unit during noninvasive ventilation: an international survey.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
- Reconsidering methodological choices and future research avenues in awake prone positioning studies.Intensive care medicine · 2025Article
- Cardiorespiratory Stability in Critically Ill Preterm Infants following Dexmedetomidine Initiation.American journal of perinatology · 2025Article
- Hemodynamic Effects of Positive Airway Pressure: A Cardiologist's Overview.Journal of cardiovascular development and disease · 2025Review
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
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 5 institutions in 3 countries.
Funding
Abstract
backgroundAlthough clinical studies have evaluated dexmedetomidine as a strategy to improve noninvasive ventilation (NIV) comfort and tolerance in patients with acute respiratory failure (ARF), their results have not been summarized. RESEARCH QUESTION: Does dexmedetomidine, when compared with another sedative or placebo, reduce the risk of delirium, mortality, need for intubation and mechanical ventilation, or ICU length of stay (LOS) in adults with ARF initiated on NIV in the ICU? STUDY DESIGN AND
methodsWe electronically searched MEDLINE, EMBASE, and the Cochrane Library from inception through July 31, 2020, for randomized clinical trials (RCTs). We calculated pooled relative risks (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes with the corresponding 95% CIs using a random-effect model.
resultsTwelve RCTs were included in our final analysis (n = 738 patients). The use of dexmedetomidine, compared with other sedation strategies or placebo, reduced the risk of intubation (RR, 0.54; 95% CI, 0.41-0.71; moderate certainty), delirium (RR, 0.34; 95% CI, 0.22-0.54; moderate certainty), and ICU LOS (MD, -2.40 days; 95% CI, -3.51 to -1.29 days; low certainty). Use of dexmedetomidine was associated with an increased risk of bradycardia (RR, 2.80; 95% CI, 1.92-4.07; moderate certainty) and hypotension (RR, 1.98; 95% CI, 1.32-2.98; moderate certainty).
interpretationCompared with any sedation strategy or placebo, dexmedetomidine reduced the risk of delirium and the need for mechanical ventilation while increasing the risk of bradycardia and hypotension. The results are limited by imprecision, and further large RCTs are needed. TRIAL REGISTRY: PROSPERO; No.: 175086; URL: www.crd.york.ac.uk/prospero/.
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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.