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Halogenated anesthetics vs intravenous hypnotics for short and long term sedation in the intensive care unit: A meta-analysisстатья
- Авторы: Likhvantsev V., Landoni G., Ermokhina N., Yadgarov M., Berikashvili L., Kadantseva K., Grebenchikov O., Okhinko L., Kuzovlev A.
- Журнал: Medicina Intensiva
- Год издания: 2022
- Издательство: Ediciones Doyma S.A.
- Местоположение издательства: Spain
- DOI: 10.1016/j.medin.2022.03.007
- Аннотация: ObjectiveTo comprehensively assess peer-reviewed studies using volatile (VA) or intravenous (i/v) anesthetics for sedation in intensive care units (ICUs), with the hypothesis that the type of sedation may have an impact on survival and other clinically relevant outcomes.DesignSystematic review and meta-analysis of randomized and non-randomized trials.SettingICUs.ParticipantsCritically ill and postoperative patients.InterventionsNone.Measurements and main resultsStudies comparing VA versus i/v anesthetics used in the ICU settings were independently systematically searched. Finally, 15 studies (1520 patients of predominantly surgical profile needed VA sedation for less than 96 h) were included. VA had no impact on all-cause mortality (very low quality of evidence, Odds Ratio = 0.82 [0.60–1.12], p = 0.20). However, VA were associated with a reduction in duration of mechanical ventilation (p = 0.03) and increase in ventilator-free days (p < 0.001). VA also reduced postoperative levels of cardiac troponin (24 h), time to extubation (p < 0.001) and awakening (p = 0.04).ConclusionsIn this meta-analysis, volatile sedation vs propofol caused the increase in ventilator-free days, the reduction in the duration of mechanical ventilation, time to extubation and the troponin release in medical or surgical ICU patients, while in surgical ICU patients the time to awakening was shortened.
- Добавил в систему: Ядгаров Михаил Яковлевич