Evidence map›Paper›PMID 40939457›Full record

ArticleJournal of critical care2026

Sedation practices and associated clinical outcomes among adult ICU patients managed by advanced practice providers versus resident physicians.

Jenny Shah, Amy L Dzierba, Justin Muir, Anne Meier, Paula Peeler-Remy, Daniel Brodie, Natalie Yip, Alexis L Serra, Jeremy R Beitler

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Jenny ShahDepartment of Pharmacy, New York-Presbyterian Hospital, New York, NY, USA. Electronic address: jes9386@nyp.org.
Amy L DzierbaASPIRE Trials Program, New York University Grossman School of Medicine, New York, NY, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, New York University, New York, NY, USA.
Justin MuirDepartment of Pharmacy, New York-Presbyterian Hospital, New York, NY, USA.
Anne MeierDivision of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Paula Peeler-RemyDivision of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Daniel BrodieDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Natalie YipDivision of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Alexis L SerraASPIRE Trials Program, New York University Grossman School of Medicine, New York, NY, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, New York University, New York, NY, USA.
Jeremy R BeitlerASPIRE Trials Program, New York University Grossman School of Medicine, New York, NY, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, New York University, New York, NY, USA.

Funding

Respiratory Drive in Acute Respiratory FailureR01HL168102 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Jeremy R. Beitler · 2023 to 2026
$3.2M
NHLBI NIH HHS R01 HL168102
6 · The paper itself

Abstract

backgroundIntensive care unit (ICU) staffing models increasingly use advanced practice providers (APPs), with unclear implications for clinical practice patterns. Sedation strategy is a modifiable determinant of clinical outcomes that might differ by staffing model.

methodsThis retrospective cohort study evaluated adults admitted to two medical ICUs in a quaternary teaching hospital, whose staffing differed only by APPs or residents. Patients requiring invasive ventilation for at least 48 h were included. The primary outcome was association of staffing model with sedative exposure during the first week of mechanical ventilation. Time to extubation and vital status at discharge were also assessed.

resultsOf 337 included patients, 96 % received continuous sedation on the day of intubation. Admission to the APP ICU was associated with significantly lower benzodiazepine exposure (adjusted OR 0.63; 95 % CI 0.40-0.99; p = 0.04) and higher propofol exposure (adjusted OR 1.73; 95 % CI 1.07-2.79; p = 0.03) on day of intubation. Cumulative benzodiazepine and opioid exposures over the first week after intubation were significantly less, and cumulative propofol exposure significantly more in the APP ICU despite similar sedation depth achieved between ICUs. Receipt of propofol on the first day was associated with shorter time to extubation (adjusted HR 1.45, 95 % CI 1.07-1.98; p = 0.02) and lower in-hospital mortality (adjusted OR 0.55, 95 % CI 0.33-0.93; p = 0.02).

conclusionPatients admitted to an APP-staffed ICU were more likely to have sedation management reflective of best practice, and this practice was associated with shorter time to extubation and lower mortality.

Indexed as

Hypnotics and SedativesIntensive Care UnitsInternship and ResidencyAdultAgedAnalgesics, OpioidBenzodiazepinesFemaleHospital MortalityHospitals, TeachingHumansMaleMiddle AgedPractice Patterns, Physicians'PropofolRespiration, ArtificialAnalgesics, OpioidBenzodiazepinesHypnotics and SedativesPropofolBenzodiazepinesHospital personnelPropofolRespiratory failureSedatives

Identifiers

PMID40939457
PMCPMC13526468

What OpenQuestion holds

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Registered trials

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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.