Sedation of mechanically ventilated adults in intensive care unit: a network meta-analysis.
Sedatives are commonly used for mechanically ventilated patients in intensive care units (ICU). However, a variety of sedatives are available and their efficacy and safety have been compared in numerous trials with inconsistent results. To resolve uncertainties regarding usefulness of these sedatives, we performed a systematic review and network meta-analysis. Randomized controlled trials comparing sedatives in mechanically ventilated ICU patients were included. Graph-theoretical methods were employed for network meta-analysis. A total of 51 citations comprising 52 RCTs were included in our analysis. Dexmedetomidine showed shorter MV duration than lorazepam (mean difference (MD): 68.7; 95% CI: 18.2-119.3 hours), midazolam (MD: 10.2; 95% CI: 7.7-12.7 hours) and propofol (MD: 3.4; 95% CI: 0.9-5.9 hours). Compared with dexmedetomidine, midazolam was associated with significantly increased risk of delirium (OR: 2.47; 95% CI: 1.17-5.19). Our study shows that dexmedetomidine has potential benefits in reducing duration of MV and lowering the risk of delirium.
Department of emergency medicine, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.
Zhongheng
Z
Zhang
Department of critical care medicine, Jinhua municipal central hospital, Jinhua hospital of Zhejiang university, Zhejiang, P. R. China.
Kun
K
Chen
Department of critical care medicine, Jinhua municipal central hospital, Jinhua hospital of Zhejiang university, Zhejiang, P. R. China.
Hongying
H
Ni
Department of critical care medicine, Jinhua municipal central hospital, Jinhua hospital of Zhejiang university, Zhejiang, P. R. China.
Xiaoling
X
Zhang
Department of critical care medicine, Jinhua municipal central hospital, Jinhua hospital of Zhejiang university, Zhejiang, P. R. China.
Haozhe
H
Fan
D003422:Critical Care / Q000379:methods; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007362:Intensive Care Units; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D017594:Publication Bias; D012121:Respiration, Artificial
D006993:Hypnotics and Sedatives