SynthesisPloS one2023
A comparation of dexmedetomidine and midazolam for sedation in patients with mechanical ventilation in ICU: A systematic review and meta-analysis.
Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Comparison of the effects of dexmedetomidine and lidocaine on postoperative analgesia and recovery characteristics: a meta-analysis of randomized controlled trials.Systematic reviews · 2026Pooled it
- 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
- Association between the use of midazolam, fentanyl, propofol, ketamine, and dexmedetomidine and the incidence of delirium in elderly patients in intensive care units: a systematic review.Sao Paulo medical journal = Revista paulista de medicina · 2025Pooled it
- The Effect of Low-Dose Dexmedetomidine Nasal Spray on Anxiety Levels in Gynaecological Patients on the Day of Surgery: A Randomised Controlled Study.Drug design, development and therapy · 2026Trial
- Hemodynamic Effects of Anesthetics, Sedatives, and Analgesics in the CICU: Clinical Decision Guidance.JACC. Advances · 2026Review
- Burden of and risk factors for neurological complications in critical illness.Intensive care medicine · 2026Review
- Association of Acute Kidney Injury and Chronic Kidney Disease With Concentration-To-Dose Ratios of Midazolam and Its Main Metabolites in Critically Ill Adults.Fundamental & clinical pharmacology · 2026Observational
- Perioperative Anxiety in Adults: A Narrative Review of Pathophysiology, Assessment, and Multimodal Management Strategies.Healthcare (Basel, Switzerland) · 2026Review
- Minimizing hospital acquired intensive care unit infections: A focus on prevention.World journal of critical care medicine · 2026Review
- Efficacy and safety of dexmedetomidine versus midazolam for sedation in mechanically ventilated pediatric patients: a randomized clinical trial.Journal of anesthesia, analgesia and critical care · 2026Article
- The effect of dexmedetomidine on rocuronium-induced neuromuscular blockade and its reversal by sugammadex.Intensive care medicine experimental · 2026Article
- Real-World Evidence for Combination Sedation: Propofol Plus Dexmedetomidine and Clinical Outcomes in Mechanically Ventilated ICU Patients.Therapeutics and clinical risk management · 2026Article
- Dexmedetomidine in Palestinian intensive care units: The first multicenter cross-sector survey of sedation practices, protocol gaps, and withdrawal challenges.SAGE open medicine · 2026Article
- Dexmedetomidine vs. midazolam-fentanyl for intraoperative analgesia and sedation: a systematic review and meta analysis.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- Dexmedetomidine's Role in Adult ICU After 20 Years of Experience-A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Review
- Intranasal Dexmedetomidine vs. Oral Midazolam in Pediatric Emergence Agitation Management Following Anesthesia; A Double Blind Randomized Clinical Trial.Archives of academic emergency medicine · 2025Article
- Impact of Dexmedetomidine on Hospital and Intensive Care Unit Stay Duration in Adult Traumatic Brain Injury Patients: A Systematic Review.Drug, healthcare and patient safety · 2025Review
- Delirium and Its Associations with Critical Care Utilizations and Outcomes at the Time of Hospital Discharge in Patients with Acute Brain Injury.Medicina (Kaunas, Lithuania) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of dexmedetomidine rather than midazolam may improve ICU outcomes. We summarized the available recent evidence to further verify this conclusion.
methodsAn electronic search of PubMed, Medline, Embase, Cochrane Library, and Web of Science was conducted. Risk ratios (RR) were used for binary categorical variables, and for continuous variables, weighted mean differences (WMD) were calculated, the effect sizes are expressed as 95% confidence intervals (CI), and trial sequential analysis was performed.
results16 randomized controlled trials were enrolled 2035 patients in the study. Dexmedetomidine as opposed to midazolam achieved a shorter length of stay in ICU (MD = -2.25, 95%CI = -2.94, -1.57, p<0.0001), lower risk of delirium (RR = 0.63, 95%CI = 0.50, 0.81, p = 0.0002), and shorter duration of mechanical ventilation (MD = -0.83, 95%CI = -1.24, -0.43, p<0.0001). The association between dexmedetomidine and bradycardia was also found to be significant (RR 2.21, 95%CI 1.31, 3.73, p = 0.003). We found no difference in hypotension (RR = 1.44, 95%CI = 0.87, 2.38, P = 0.16), mortality (RR = 1.02, 95%CI = 0.83, 1.25, P = 0.87), neither in terms of adverse effects requiring intervention, hospital length of stay, or sedation effects.
conclusionsCombined with recent evidence, compared with midazolam, dexmedetomidine decreased the risk of delirium, mechanical ventilation, length of stay in the ICU, as well as reduced patient costs. But dexmedetomidine could not reduce mortality and increased the risk of bradycardia.
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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.