Abstract
Strategies aiming light sedation are associated with decreased length on mechanical ventilation. However, awake or easily arousable patients may be prone to greater prevalence of posttraumatic stress disorder (PTSD). These systematic review and meta-analysis aimed to evaluate the safety of light sedation strategies regarding the prevalence of PTSD. We searched MEDLINE, Scopus, and Web of Science from inception to November 2014 for randomized controlled trials that evaluated light sedation strategies and addressed PTSD prevalence in the follow-up as a specific outcome. Because not all trials performed the same comparisons, we performed a network meta-analysis to evaluate indirect comparisons. Five studies fulfilled our inclusion criteria and were included in the meta-analysis. Two studies compared daily sedation interruption with usual care (92 patients), 2 studies compared a light sedation protocol with daily sedation interruption (47 patients), and 1 study compared light and deep sedation (102 patients). Compared with usual sedation care/deep sedation, neither daily interruption of sedation (odds ratio=0.66; 95% confidence interval, 0.22-1.98) nor a light sedation protocol (odds ratio=0.90, 95% confidence interval, 0.27-3.05) ...Continue Reading
References
Sep 3, 1998·Chest·M H KollefG Sherman
Sep 2, 1999·Intensive Care Medicine·C StollG Schelling
Jan 11, 2000·Critical Care Medicine·A D BrookM H Kollef
May 18, 2000·The New England Journal of Medicine·J P KressJ B Hall
May 18, 2000·The New England Journal of Medicine·J E Heffner
May 25, 2001·Critical Care Medicine·C JonesP M Skirrow
Oct 4, 2003·American Journal of Respiratory and Critical Care Medicine·John P KressJesse B Hall
Jan 7, 2004·Behaviour Research and Therapy·Mark CreamerSalvina Failla
Feb 24, 2007·Critical Care : the Official Journal of the Critical Care Forum·Timothy D GirardE Wesley Ely
Mar 27, 2007·Intensive Care Medicine·C JonesR D Griffiths
Apr 4, 2007·Intensive Care Medicine·Sébastien OuimetYoanna Skrobik
Jun 15, 2007·Intensive Care Medicine·John GriffithsJ Duncan Young
Jan 15, 2008·Lancet·Timothy D GirardE Wesley Ely
Sep 9, 2008·General Hospital Psychiatry·Dimitry S DavydowO Joseph Bienvenu
Jul 16, 2009·Critical Care Medicine·Miriam M TreggiariNoel S Weiss
Aug 6, 2009·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·John P A Ioannidis
Feb 2, 2010·Lancet·Thomas StrømPalle Toft
Mar 20, 2010·American Journal of Respiratory and Critical Care Medicine·James C JacksonE Wesley Ely
Sep 17, 2010·Critical Care : the Official Journal of the Critical Care Forum·Christina JonesUNKNOWN RACHEL group
Jul 26, 2011·BMJ : British Medical Journal·Jonathan A C SterneJulian P T Higgins
Dec 15, 2011·Critical Care : the Official Journal of the Critical Care Forum·Thomas StrømPalle Toft
Oct 17, 2012·Critical Care : the Official Journal of the Critical Care Forum·Dorothy M WadeRosalind A Raine
May 16, 2013·BMJ : British Medical Journal·Edward J MillsJohn P A Ioannidis
Jun 6, 2014·Annals of Intensive Care·Antonio Paulo Nassar Junior, Marcelo Park
Jul 17, 2014·Revista Brasileira de terapia intensiva·Jaquilene Barreto da CostaPéricles Almeida Delfino Duarte
Jul 23, 2014·Critical Care : the Official Journal of the Critical Care Forum·Lilian Maria Sobreira TanakaJorge Ibrain Figueira Salluh
Dec 30, 2014·PloS One·Binod NeupaneJoseph Beyene
Feb 13, 2015·Critical Care : the Official Journal of the Critical Care Forum·Otavio T RanzaniUNKNOWN AMIL Critical Care Group