Evidence map›Paper›PMID 36419197›Full record

Trial reportCritical care (London, England)2022

Stress response during early sedation with dexmedetomidine compared with usual-care in ventilated critically ill patients.

John P R Moore, Yahya Shehabi, Michael C Reade, Michael Bailey, John F Fraser, Lauren Murray, Christopher Anstey, Mervyn Singer

Open access · goldAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
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  5. Review
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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

8 authors at 7 institutions in 2 countries.

John P R MooreDepartment of Intensive Care, Sunshine Coast University Hospital, 6 Doherty St, Birtinya, QLD, 4575, Australia. john.moore@health.qld.gov.au.
Yahya ShehabiMonash Health School of Clinical Sciences, Monash University, Melbourne, Australia.
Michael C ReadeFaculty of Medicine, University of Queensland, Brisbane, Australia.
Michael BaileyAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia.
John F FraserCritical Care Research Group, University of Queensland and The Prince Charles Hospital, Brisbane, Australia.
Lauren MurrayDepartment of Intensive Care, Sunshine Coast University Hospital, 6 Doherty St, Birtinya, QLD, 4575, Australia.
Christopher AnsteySchool of Medicine, Griffith University, Southport, QLD, Australia.
Mervyn SingerBloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
Sunshine Coast University Hospital · AUBury College · GBGriffith University · AUMonash Health · AUMonash University · AUPrince Charles Hospital · AUUniversity of Queensland · AU

Funding

Sunshine Coast Hospital and Health Service SERTF 2016-017Wishlist 2016-08
6 · The paper itself

Abstract

backgroundSedative agents may variably impact the stress response. Dexmedetomidine is a sympatholytic alpha

methodsThis was a prospective sub-study nested within a multi-centre randomised controlled trial of early sedation with dexmedetomidine versus usual care. The primary outcome was the mean group differences in plasma levels of stress response biomarkers measured over 5 days following randomisation. Other hormonal, biological and physiological parameters were collected. Subgroup analyses were planned for patients with proven or suspected sepsis.

resultsOne hundred and three patients were included in the final analysis. Baseline illness severity (APACHE II score), the proportion of patients receiving propofol and the median dose of propofol received were comparable between groups. More of the usual-care patients received midazolam (57.7% vs 33.3%; p = 0.01) and at higher dose (median (95% interquartile range) 0.46 [0.20-0.93] vs 0.14 [0.08-0.38] mg/kg/day; p < 0.01). The geometric mean (95% CI) plasma level of the stress hormones, adrenaline (0.32 [0.26-0.4] vs 0.38 [0.31-0.48]), noradrenaline (4.27 [3.12-5.85] vs 6.2 [4.6-8.5]), adrenocorticotropic hormone (17.1 [15.1-19.5] vs 18.1 [15.9-20.5]) and cortisol (515 [409-648] vs 618 [491-776)] did not differ between dexmedetomidine and usual-care groups, respectively. There were no significant differences in any other assayed biomarkers or physiological parameters Sensitivity analyses showed no effect of age or sepsis.

conclusionsEarly sedation with dexmedetomidine as the primary sedative agent in mechanically ventilated critically ill adults resulted in comparable changes in physiological and blood-borne parameters associated with the stress-response as with usual-care sedation.

Indexed as

DexmedetomidinePropofolSepsisAdrenergic alpha-2 Receptor AgonistsAdultCritical IllnessHumansHypnotics and SedativesIntensive Care UnitsProcedural SedationProspective StudiesRespiration, ArtificialAdrenergic alpha-2 Receptor AgonistsDexmedetomidineHypnotics and SedativesPropofolAllostasisCritical illnessMultiple organ failureSedatives

Identifiers

PMID36419197
PMCPMC9682690
OpenAlexW4309728361

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.