Different depths of sedation versus risk of delirium in adult mechanically ventilated patients: A systematic review and meta-analysis

PloS One
Ling LongPenglin Ma

Abstract

Delirium is multifactorial. This study aimed at determining the association between different depths of sedation and the risk of delirium in adult mechanically ventilated patients. A systematic literature retrieval was conducted in databases including Cochrane Central Register of Controlled Trials, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature for publications available till December 2019 without limitation in study type, and followed by a secondary retrieval for related literature. STATA15.1 and WinBugs 14.3 were used in statistical analyses for different sedation depths as the intervention. The main endpoint was delirium occurrence. Secondary endpoints were agitation-related adverse events and mortality. We included 18 studies comprising 8001 mechanically ventilated patients. Different sedation depths were not associated with the occurrence of delirium (OR = 1.00, 95%CI: 0.64-1.58, P = 0.993). Among the 18 enrolled studies, this finding was not confounded by the dosage of benzodiazepines (OR = 0.96, 95%CI: 0.79-1.17, P = 0.717) in eight randomized controlled trials(RCTs) or the patients' disease severity(OR 0.95, 95%CI: 0.79-1.13, P = 0.548) in 10 RCTs. However, contrasting results were found in non...Continue Reading

References

Jun 22, 1974·British Medical Journal·M A RamsayR Goodwin
Mar 4, 2000·The Journal of Neuropsychiatry and Clinical Neurosciences·D J MeagherP T Trzepacz
Jun 12, 2003·JAMA : the Journal of the American Medical Association·E Wesley ElyGordon R Bernard
Apr 15, 2004·JAMA : the Journal of the American Medical Association·E Wesley ElyRobert S Dittus
Dec 13, 2007·JAMA : the Journal of the American Medical Association·Pratik P PandharipandeE Wesley Ely
Dec 4, 2008·Critical Care Medicine·Margaret A PisaniSharon K Inouye
May 22, 2009·Critical Care : the Official Journal of the Critical Care Forum·Bart Van RompaeyLeo Bossaert
Jul 16, 2009·Critical Care Medicine·Miriam M TreggiariNoel S Weiss
Dec 27, 2011·International Journal of Nursing Studies·Mark van den BoogaardPeter Pickkers
Aug 4, 2012·American Journal of Respiratory and Critical Care Medicine·Yahya ShehabiUNKNOWN ANZICS Clinical Trials Group
Aug 21, 2012·Intensive Care Medicine·Timothy D GirardE Wesley Ely
Oct 25, 2012·Intensive Care Medicine·Irene J ZaalArjen J C Slooter
Dec 25, 2012·Critical Care Medicine·John A McPhersonPratik P Pandhvaripande
Dec 28, 2012·Critical Care Medicine·Juliana BarrUNKNOWN American College of Critical Care Medicine
Mar 20, 2013·Critical Care Medicine·David N HagerDale M Needham
Jul 19, 2013·Critical Care Medicine·Yahya ShehabiUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Oct 4, 2013·The New England Journal of Medicine·P P PandharipandeUNKNOWN BRAIN-ICU Study Investigators
Dec 25, 2013·Annals of the American Thoracic Society·S Jean HsiehMichelle N Gong
Jan 31, 2014·The New England Journal of Medicine·Michael C Reade, Simon Finfer
Mar 7, 2014·Annals of the American Thoracic Society·Christopher R DaleMiriam M Treggiari
Jul 23, 2014·Critical Care : the Official Journal of the Critical Care Forum·Lilian Maria Sobreira TanakaJorge Ibrain Figueira Salluh
Sep 25, 2014·Critical Care Medicine·Irene J ZaalArjen J C Slooter
Dec 4, 2014·Journal of Critical Care·Louise RoseUNKNOWN Canadian Critical Care Trials Group
Apr 19, 2015·Critical Care : the Official Journal of the Critical Care Forum·Lee P SkrupkyWalter A Boyle
May 1, 2015·Critical Care : the Official Journal of the Critical Care Forum·Felix BalzerMarc Kastrup
Apr 15, 2016·Intensive Care Medicine·Jean-Louis VincentJukka Takala
Mar 23, 2017·JAMA : the Journal of the American Medical Association·Yu KawazoeUNKNOWN Dexmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) Trial Investigators
Jul 10, 2018·Critical Care Medicine·Lotte KokDieuwke S Veldhuijzen

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Software Mentioned

STATA15
Cochrane Risk of Bias Tool

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

American Journal of Respiratory and Critical Care Medicine
Jukka Takala
Intensive Care Medicine
Nathan E Brummel, E Wesley Ely
The Lancet. Respiratory Medicine
Valerie J Page
The New England Journal of Medicine
Bert Govig
© 2021 Meta ULC. All rights reserved