ArticleCritical care medicine2024
Analgesia and Sedation Use During Noninvasive Ventilation for Acute Respiratory Failure.
Article in Critical care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Dexmedetomidine for acute respiratory conditions requiring non-invasive respiratory support in pediatric and adult patients: systematic review and meta-analysis of the literature.Frontiers in medicine · 2026Pooled it
- Dexmedetomidine for sedation during noninvasive ventilation in COVID-19 patients from the Helmet-COVID randomized clinical trial post-hoc analysis.Scientific reports · 2026Trial
- Effect of lateral versus supine positioning on hypoxaemia in sedated adults: multicentre randomised controlled trial.BMJ (Clinical research ed.) · 2025Trial
- Use of Sedation During Non-Invasive Ventilation in Intensive Care Unit: A Systematic Review and Meta-Analysis.Journal of personalized medicine · 2026Review
- Analgosedation During the Use of Non-Invasive Respiratory Supports: A Synthesis of Clinical Evidence and Best Practices.Journal of clinical medicine · 2026Review
- High-flow nasal oxygen versus noninvasive ventilation in acute respiratory failure: reflections on the RENOVATE trial.Journal of thoracic disease · 2026Article
- Impact of relaxation training and sedative medication use on respiratory recovery in hospitalized patients with respiratory diseases: a retrospective observational study.Frontiers in medicine · 2026Article
- Opioids and Respiratory Related Consequences.Sleep medicine clinics · 2025Review
- Developing A Data Pipeline to Quantify Ventilator Waveforms.medRxiv : the preprint server for health sciences · 2025Article
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
- Analgosedation in patients with acute respiratory failure on noninvasive ventilation: is it truly safe?Journal of anesthesia, analgesia and critical care · 2024Article
- Remifentanil vs. dexmedetomidine for cardiac surgery patients with noninvasive ventilation intolerance: a multicenter randomized controlled trial.Journal of intensive care · 2024Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo describe U.S. practice regarding administration of sedation and analgesia to patients on noninvasive ventilation (NIV) for acute respiratory failure (ARF) and to determine the association of this practice with odds of intubation or death.
designA retrospective multicenter cohort study.
settingA total of 1017 hospitals contributed data between January 2010 and September 2020 to the Premier Healthcare Database, a nationally representative healthcare database in the United States. PATIENTS: Adult (≥ 18 yr) patients admitted to U.S. hospitals requiring NIV for ARF.
interventionsNone. MEASUREMENTS AND MAIN
resultsWe identified 433,357 patients on NIV of whom (26.7% [95% CI] 26.3%-27.0%) received sedation or analgesia. A total of 50,589 patients (11.7%) received opioids only, 40,646 (9.4%) received benzodiazepines only, 20,146 (4.6%) received opioids and benzodiazepines, 1.573 (0.4%) received dexmedetomidine only, and 2,639 (0.6%) received dexmedetomidine in addition to opioid and/or benzodiazepine. Of 433,357 patients receiving NIV, 50,413 (11.6%; 95% CI, 11.5-11.7%) patients underwent invasive mechanical ventilation on hospital days 2-5 or died on hospital days 2-30. Intubation was used in 32,301 patients (7.4%; 95% CI, 7.3-7.6%). Further, death occurred in 24,140 (5.6%; 95% CI, 5.5-5.7%). In multivariable analysis adjusting for relevant covariates, receipt of any medication studied was associated with increased odds of intubation or death. In inverse probability weighting, receipt of any study medication was also associated with increased odds of intubation or death (average treatment effect odds ratio 1.38; 95% CI, 1.35-1.40).
conclusionsThe use of sedation and analgesia during NIV is common. Medication exposure was associated with increased odds of intubation or death. Further investigation is needed to confirm this finding and determine whether any subpopulations are especially harmed by this practice.
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