Evidence map›Paper›PMID 36691212›Full record

ArticleBMJ open2022

Level of sedation in critically ill adult patients: a protocol for a systematic review with meta-analysis and trial sequential analysis.

Ameldina Ceric, Johan Holgersson, Teresa May, Markus B Skrifvars, Johanna Hästbacka, Manoj Saxena, Anders Aneman, Anthony Delaney, Michael C Reade, Candice Delcourt and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 38% 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

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. 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

12 authors at 9 institutions in 5 countries.

Ameldina CericDepartment of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Helsingborg Hospital, Helsingborg, Sweden ameldina.ceric@med.lu.se.ORCID 0000-0001-6846-5961
Johan HolgerssonDepartment of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Helsingborg Hospital, Helsingborg, Sweden.
Teresa MayDepartment of Critical Care, Maine Medical Center, Portland, Maine, USA.
Markus B SkrifvarsDepartment of Emergency Care and Services, Helsinki University, Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-0341-0262
Johanna HästbackaDepartment of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Manoj SaxenaSenior Lecturer, Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Anders AnemanIntensive Care Unit, South Western Sydney Local Health District, Liverpool Hospital, South Western Sydney Local Health District, South Western Sydney Clinical School, University of New South Wales, and Faculty of Medicine, Health and Human Sciences, Macquarie University, Liverpool, New South Wales, Australia.
Anthony DelaneyThe George Institute for Global Health and the University of New South Wales, Sydney, New South Wales, Australia.
Michael C ReadeDepartment of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Denmark, Denmark.ORCID 0000-0003-1570-0707
Candice DelcourtDepartment of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0003-2257-4286
Janus JakobsenDepartment of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Denmark, Denmark.
Niklas NielsenDepartment of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Helsingborg Hospital, Helsingborg, Sweden.
Lund University · SEUniversity of Southern Denmark · DKHelsinki University Hospital · FILiverpool Hospital · AUMacquarie University · AUMaine Medical Center · USRoyal North Shore Hospital · AUUniversity of Helsinki · FIUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIt is standard of care to provide sedation to critically ill patients to reduce anxiety, discomfort and promote tolerance of mechanical ventilation. Given that sedatives can have differing effects based on a variety of patient and pharmacological characteristics, treatment approaches are largely based on targeting the level of sedation. The benefits of differing levels of sedation must be balanced against potential adverse effects including haemodynamic instability, causing delirium, delaying awakening and prolonging the time of mechanical ventilation and intensive care stay. This systematic review with meta-analysis aims to investigate the current evidence and compare the effects of differing sedation levels in adult critically ill patients. METHODS AND ANALYSES: We will conduct a systematic review based on searches of preidentified major medical databases (eg, MEDLINE, EMBASE, CENTRAL) and clinical trial registries from their inception onwards to identify trials meeting inclusion criteria. We will include randomised clinical trials comparing any degree of sedation with no sedation and lighter sedation with deeper sedation for critically ill patients admitted to the intensive care unit. We will include aggregate data meta-analyses and trial sequential analyses. Risk of bias will be assessed with domains based on the Cochrane risk of bias tool. An eight-step procedure will be used to assess if the thresholds for clinical significance are crossed, and the certainty of the evidence will be assessed using Grades of Recommendations, Assessment, Development and Evaluation. ETHICS AND DISSEMINATION: No formal approval or review of ethics is required as individual patient data will not be included. This systematic review has the potential to highlight (1) whether one should believe sedation to be beneficial, harmful or neither in critically ill adults; (2) the existing knowledge gaps and (3) whether the recommendations from guidelines and daily clinical practice are supported by current evidence. These results will be disseminated through publication in a peer-reviewed journal.

Indexed as

Critical IllnessHypnotics and SedativesAdultCritical CareHumansIntensive Care UnitsLength of StayMeta-Analysis as TopicRandomized Controlled Trials as TopicSystematic Reviews as TopicHypnotics and SedativesAdult anaesthesiaAdult intensive & critical careAnaesthesia in cardiologyAnaesthesia in neurology

Identifiers

PMID36691212
PMCPMC9462111
OpenAlexW4294958962

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.