Evidence map›Paper›PMID 35648198›Full record

SynthesisIntensive care medicine2022

Dexmedetomidine vs other sedatives in critically ill mechanically ventilated adults: a systematic review and meta-analysis of randomized trials.

Kimberley Lewis, Fayez Alshamsi, Kallirroi Laiya Carayannopoulos, Anders Granholm, Joshua Piticaru, Zainab Al Duhailib, Dipayan Chaudhuri, Laura Spatafora, Yuhong Yuan, John Centofanti and 18 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 13 pooled it
22.1field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 13 syntheses or guidelines pooled it, 157 citations in OpenAlex.

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  4. [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025
    Guideline
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34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 15 institutions in 8 countries.

Kimberley LewisDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada. lewiska@mcmaster.ca.ORCID http://orcid.org/0000-0001-6610-3369
Fayez Alshamsi *Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Alain, United Arab Emirates.
Kallirroi Laiya Carayannopoulos *Division of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Anders Granholm *Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Joshua Piticaru *Division of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Zainab Al DuhailibDepartment of Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Dipayan ChaudhuriDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Laura SpataforaDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Yuhong YuanDivision of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Canada.
John CentofantiDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Jessica SpenceDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Bram RochwergDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Dan PerriDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Dale M NeedhamDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, USA.
Anne HolbrookDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
John W DevlinSchool of Pharmacy, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Northeastern University, Boston, MA, USA.
Osamu NishidaDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan.
Kimia HonarmandDivision of Critical Care Medicine, Department of Medicine, Western University, London, Canada.
Begüm ErganDepartment of Pulmonary and Critical Care, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Eugenia KhorochkovDepartment of Medical Imaging, Memorial University of Newfoundland, St. John's, Canada.
Pratik PandharipandeDivision of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA.
Mohammed AlshahraniDepartment of Emergency and Critical Care, College of Medicine, Imam Abdulrahman Ben Faisal University, Al Khobar, Kingdom of Saudi Arabia.
Tim KarachiDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Mark SothDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
Yahya ShehabiDepartment of Intensive Care, Monash Health School of Clinical Sciences, The School of Clinical Medicine, University of New South Wales, Clayton, VIC 3168, Randwick, 2031, Australia.
Morten Hylander MøllerDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Waleed AlhazzaniDivision of Critical Care, Intensive Care Unit, Department of Medicine, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Ave E, Hamilton, ON, L8N 4A, Canada.
GUIDE group
St. Joseph’s Healthcare Hamilton · CAImpact · CACopenhagen University Hospital · DKBrigham and Women's Hospital · USDokuz Eylül University · TRFujita Health University · JPJohns Hopkins University · USKing Faisal Specialist Hospital & Research Centre · SAMcMaster University · CAMemorial University of Newfoundland · CAPopulation Health Research Institute · CAUnited Arab Emirates University · AEUNSW Sydney · AUVanderbilt University Medical Center · USWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Conventional gabaminergic sedatives such as benzodiazepines and propofol are commonly used in mechanically ventilated patients in the intensive care unit (ICU). Dexmedetomidine is an alternative sedative that may achieve lighter sedation, reduce delirium, and provide analgesia. Our objective was to perform a comprehensive systematic review summarizing the large body of evidence, determining if dexmedetomidine reduces delirium compared to conventional sedatives. We searched MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov and the WHO ICTRP from inception to October 2021. Independent pairs of reviewers identified randomized clinical trials comparing dexmedetomidine to other sedatives for mechanically ventilated adults in the ICU. We conducted meta-analyses using random-effects models. The results were reported as relative risks (RRs) for binary outcomes and mean differences (MDs) for continuous outcomes, with corresponding 95% confidence intervals (CIs). In total, 77 randomized trials (n = 11,997) were included. Compared to other sedatives, dexmedetomidine reduced the risk of delirium (RR 0.67, 95% CI 0.55 to 0.81; moderate certainty), the duration of mechanical ventilation (MD - 1.8 h, 95% CI  - 2.89 to  - 0.71; low certainty), and ICU length of stay (MD  - 0.32 days, 95% CI  - 0.42 to  - 0.22; low certainty). Dexmedetomidine use increased the risk of bradycardia (RR 2.39, 95% CI 1.82 to 3.13; moderate certainty) and hypotension (RR 1.32, 95% CI 1.07 to 1.63; low certainty). In mechanically ventilated adults, the use of dexmedetomidine compared to other sedatives, resulted in a lower risk of delirium, and a modest reduction in duration of mechanical ventilation and ICU stay, but increased the risks of bradycardia and hypotension.

Indexed as

DeliriumDexmedetomidineHypotensionAdultBradycardiaCritical IllnessHumansHypnotics and SedativesIntensive Care UnitsRandomized Controlled Trials as TopicRespiration, ArtificialDexmedetomidineHypnotics and SedativesDeliriumDexmedetomidineIntensive care unitInvasive mechanical ventilationSedation

Identifiers

PMID35648198
OpenAlexW4281833693

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.