Evidence map›Paper›PMID 39350290›Full record

ArticleJournal of anesthesia, analgesia and critical care2024

Management of analgosedation during noninvasive respiratory support: an expert Delphi consensus document developed by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).

G Spinazzola, S Spadaro, G Ferrone, S Grasso, S M Maggiore, G Cinnella, L Cabrini, G Cammarota, J G Maugeri, R Simonte and 7 more

Abstract read
In one paragraph

Article in Journal of anesthesia, analgesia and critical care, 2024. 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
–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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  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

17 authors.

G SpinazzolaDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
S SpadaroDepartment of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy.
G FerroneDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. giuliano.ferrone@policlinicogemelli.it.
S GrassoDepartment of Emergency and Organ Transplantation (DETO), Section of Anesthesiology and Intensive Care, University of Bari "Aldo Moro'', Bari, Italy.
S M MaggioreDepartment of Anesthesia, Intensive Care and Emergency, SS Annunziata Chieti Hospital, G. D'Annunzio Chieti University Pescara, Pescara, Italy.
G CinnellaDepartment of Anesthesia and Intensive Care of University of Foggia, Foggia, Italy.
L CabriniDepartment of Biotechnology and Life Sciences, University of Pennsylvania Studies of Insubria, Varese, Italy.
G CammarotaDepartment of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
J G MaugeriAnesthesia and Intensive Care Unit, ARNAS Garibaldi Catania, PO "Garibaldi Centro, Catania, Italy.
R SimonteDepartment of Medicine and Surgery, Università Degli Studi Di Perugia, Perugia, Italy.
N PatronitiAnesthesia and Intensive Care San Martino Di Genova, Department of Surgical Sciences and Integrated Diagnosis, University of Genoa, Genoa, Italy.
L BallAnesthesia and Intensive Care San Martino Di Genova, Department of Surgical Sciences and Integrated Diagnosis, University of Genoa, Genoa, Italy.
G ContiDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
D De LucaDivision of Paediatrics and Neonatal Critical Care, "A. Béclère" Hospital, APHP-Paris Saclay University, Paris, France.
A CortegianiDepartment of Precision Medicine in Area Medical, Surgical and Critical Care. Anesthesia Unit, Resuscitation, and Intensive Care, AOU Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy.
A GiarratanoDepartment of Precision Medicine in Area Medical, Surgical and Critical Care. Anesthesia Unit, Resuscitation, and Intensive Care, AOU Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy.
C GregorettiIntensive Care Unit, Fondazione G. Giglio, Cefalù, Unicamillus International University, Roma, Cefalù, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiscomfort can be the cause of noninvasive respiratory support (NRS) failure in up to 50% of treated patients. Several studies have shown how analgosedation during NRS can reduce the rate of delirium, endotracheal intubation, and hospital length of stay in patients with acute respiratory failure. The purpose of this project was to explore consensus on which medications are currently available as analgosedatives during NRS, which types of patients may benefit from analgosedation while on NRS, and which clinical settings might be appropriate for the implementation of analgosedation during NRS.

methodsThe Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) selected a panel of experts and asked them to define key aspects of the use of analgesics and sedatives during NRS treatment. The methodology applied is in line with the principles of the modified Delphi and RAND-UCLA methods. The experts developed statements and supportive rationales which were then subjected to blind votes for consensus.

resultsThe use of an analgosedation strategy in adult patients with acute respiratory failure of different origins may be useful where there is a need to manage discomfort. This strategy should be considered after careful assessment of other potential factors associated with respiratory failure or inappropriate noninvasive respiratory support settings, which may, in turn, be responsible for NRS failure. Several drugs can be used, each of them specifically targeted to the main component of discomfort to treat. In addition, analgosedation during NRS treatment should always be combined with close cardiorespiratory monitoring in an appropriate clinical setting.

conclusionsThe use of analgosedation during NRS has been studied in several clinical trials. However, its successful application relies on a thorough understanding of the pharmacological aspects of the sedative drugs used, the clinical conditions for which NRS is applied, and a careful selection of the appropriate clinical setting.

Indexed as

AnalgosedationMechanical ventilationNoninvasive respiratory supportRespiratory failure

Identifiers

PMID39350290
PMCPMC11441104

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.