SynthesisBMC anesthesiology2025
Effects of sedatives on diaphragm activity monitored by ultrasound: a systematic review and meta-analysis.
Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundCurrent research lacks comprehensive evaluations on the inhibitory effects of sedatives on diaphragm activity under ultrasound monitoring. This meta-analysis aims to launch this problem by systematically analyzing the available evidence.
methodsThe EMBASE, PubMed, and Web of Science databases were searched. Original studies that explored the effects of sedative agents on human diaphragm activity via ultrasound were eligible. The quality of the included studies was evaluated using the Revised Cochrane Risk-of-Bias tool for randomized trials (RoB 2) and the Newcastle-Ottawa Scale (NOS). The pooled assessment encompassed alterations in diaphragmatic motion (DM) and diaphragmatic thickening fraction (DTF). Mean difference (MD) with 95% confidence intervals (CI) were calculated. The trial sequential analysis (TSA) was performed to calculate the required information size (RIS). The strength of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Pro Guideline Development Tool (GDT). Subgroup analysis and meta-regression was conducted to explore heterogeneity. Sensitivity analysis was used to evaluate the robustness for the meta-analysis results.
resultsSix randomized controlled trials and four prospective observational studies involving 727 patients were ultimately included. In the pooled analysis, DM and DTF were measured at three time points: during sedation (T1), upon awakening (T2), and at baseline (T0). Comparisons were conducted between the values at each time point, revealing mean differences (MDs) for DM of 2.54 mm (95% CI [2.01, 3.08], P < 0.00001, I
conclusionThis meta-analysis reveals that sedatives can inhibit diaphragm activity, with this negative impact persisting post-awakening. Propofol alone achieves a more pronounced reduction in diaphragm activity than when combined with other sedatives. However, significant heterogeneity remains across studies due to data limitations and low evidence certainty. Further research is crucial to establish evidence-based recommendations for optimal diaphragm-protective sedation strategies.
trial registrationThe protocol was registered at the PROSPERO international prospective register of systematic reviews (CRD42024514504).
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