Evidence map›Paper›PMID 35814788›Full record

ReviewFrontiers in medicine2022

Seeking the Light in Intensive Care Unit Sedation: The Optimal Sedation Strategy for Critically Ill Patients.

Nicola Gitti, Stefania Renzi, Mattia Marchesi, Michele Bertoni, Francisco A Lobo, Frank A Rasulo, Alberto Goffi, Matteo Pozzi, Simone Piva

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Frontiers in medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  16. Reckoning the Inhaled Sedation in Critically Ill Patients (INSTINCT) Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
    Article
  17. Article
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

9 authors.

Nicola GittiDepartment of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.
Stefania RenziDepartment of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.
Mattia MarchesiDepartment of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.
Michele BertoniDepartment of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy.
Francisco A LoboInstitute of Anesthesiology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Frank A RasuloDepartment of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.
Alberto GoffiInterdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Matteo PozziDepartment of Emergency and Intensive Care, San Gerardo Hospital, Monza, Italy.
Simone PivaDepartment of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The clinical approach to sedation in critically ill patients has changed dramatically over the last two decades, moving to a regimen of light or non-sedation associated with adequate analgesia to guarantee the patient's comfort, active interaction with the environment and family, and early mobilization and assessment of delirium. Although deep sedation (DS) may still be necessary for certain clinical scenarios, it should be limited to strict indications, such as mechanically ventilated patients with Acute Respiratory Distress Syndrome (ARDS), status epilepticus, intracranial hypertension, or those requiring target temperature management. DS, if not indicated, is associated with prolonged duration of mechanical ventilation and ICU stay, and increased mortality. Therefore, continuous monitoring of the level of sedation, especially when associated with the raw EEG data, is important to avoid unnecessary oversedation and to convert a DS strategy to light sedation as soon as possible. The approach to the management of critically ill patients is multidimensional, so targeted sedation should be considered in the context of the ABCDEF bundle, a holistic patient approach. Sedation may interfere with early mobilization and family engagement and may have an impact on delirium assessment and risk. If adequately applied, the ABCDEF bundle allows for a patient-centered, multidimensional, and multi-professional ICU care model to be achieved, with a positive impact on appropriate sedation and patient comfort, along with other important determinants of long-term patient outcomes.

Indexed as

dexmedetomedineICU—intensive care unitlight sedationneuromonitoringpropofol

Identifiers

PMID35814788
PMCPMC9265444

What OpenQuestion holds

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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.