SynthesisFrontiers in neurology
Dexmedetomidine vs. propofol for sedation in mechanically ventilated ICU patients: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Cipepofol versus Conventional Sedation for Pneumonia Patients Receiving Mechanical Ventilation: A Real-World Retrospective Study of Effectiveness and Hemodynamic Safety.Drug design, development and therapy · 2026Observational
- Progress of nursing management for delirium in critically ill geriatric patients: a narrative review.Frontiers in human neuroscience · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Dexmedetomidine and propofol are the two most widely used non-benzodiazepine sedatives for mechanically ventilated ICU patients. Despite guideline recommendations for both agents, the optimal choice remains controversial owing to inconsistent evidence across patient subpopulations. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) directly comparing dexmedetomidine (DEX) with propofol (PROP) in adult ICU patients requiring mechanical ventilation. Databases searched included PubMed, Embase, Cochrane CENTRAL, and CNKI. Primary outcomes were duration of mechanical ventilation (MV) and ICU length of stay (LOS). Secondary outcomes included hospital LOS, all-cause mortality, delirium incidence, bradycardia, and hypotension. Random-effects models were applied using the restricted maximum likelihood (REML) estimator with Hartung-Knapp-Sidik-Jonkman (HKSJ) confidence interval correction. Risk of bias was evaluated using the Cochrane RoB 2.0 tool. Pre-specified subgroup analyses by ICU population type and sedation duration were performed. Results: Fifteen RCTs ( Conclusion: In mechanically ventilated adult ICU patients, neither primary outcome (MV duration, ICU LOS) differed between dexmedetomidine and propofol. Dexmedetomidine may reduce ICU delirium incidence, but this secondary finding is borderline after correction for multiple comparisons and requires confirmation in dedicated trials. The higher bradycardia risk warrants vigilant haemodynamic monitoring during dexmedetomidine infusion. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261378906, identifier: CRD420261378906.
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