{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:40:24Z","timestamp":1790883624667,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,27]],"date-time":"2018-10-27T00:00:00Z","timestamp":1540598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"PROSPERO"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Delirium is common in intensive care patients. Dexmedetomidine is increasingly used for sedation in this setting, but its effect on delirium remains unclear. The primary aim of this review was to examine whether dexmedetomidine reduces the incidence of delirium and agitation in intensive care patients. We sought randomised clinical trials in\n                    <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                    ,\n                    <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                    , PubMed and\n                    <jats:styled-content style=\"fixed-case\">CENTRAL<\/jats:styled-content>\n                    from their inception until June 2018. Observational studies, case reports, case series and non\u2010systematic reviews were excluded. Twenty\u2010five trials including 3240 patients were eligible for inclusion in the data synthesis. In the patients who received dexmedetomidine (eight trials, 1425 patients), delirium was reduced, odds ratio (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    ) 0.36 (0.26\u20130.51), p\u00a0&lt;\u00a00.001 and high quality of evidence. The use of dexmedetomidine was associated with a reduced incidence of agitation, OR (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    ) 0.34 (0.20\u20130.59), p\u00a0&lt;\u00a00.001, moderate quality of evidence. Patients who were randomly assigned to dexmedetomidine had a significantly higher incidence of bradycardia, OR (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    ) 2.18 (1.46\u20133.24), p\u00a0&lt;\u00a00.001, moderate quality of evidence; and hypotension, OR (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    ) 1.89 (1.48\u20132.41), p\u00a0&lt;\u00a00.001, high quality of evidence. We found no evidence of an effect on mortality, OR (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    ) 0.86 (0.66\u20131.10), p\u00a0=\u00a00.23, moderate quality of evidence. The trial sequential analyses for the incidence of delirium, bradycardia and hypotension was conclusive but not for the incidence of agitation and mortality. In summary, this meta\u2010analysis suggests that dexmedetomidine reduces the incidence of delirium and agitation in intensive care patients. The general quality of evidence ranged from moderate to high.\n                  <\/jats:p>","DOI":"10.1111\/anae.14472","type":"journal-article","created":{"date-parts":[[2018,10,27]],"date-time":"2018-10-27T05:53:12Z","timestamp":1540619592000},"page":"380-392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta\u2010analysis with trial sequential analysis"],"prefix":"10.1111","volume":"74","author":[{"given":"K. T.","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Faculty of Medicine University of Malaya Jalan University Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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S.","family":"Chong","sequence":"additional","affiliation":[{"name":"International Medical University Bukit Jalil Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2703"},{"key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"R16","DOI":"10.1186\/cc6790","article-title":"A comparison of the CAM\u2010ICU and the NEECHAM Confusion Scale in intensive care delirium assessment: an observational study in non\u2010intubated patients","volume":"12","author":"Rompaey B","year":"2008","journal-title":"Critical Care Medicine"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc3729"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc9333"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7892"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2013.65.3.195"},{"key":"e_1_2_6_8_1","first-page":"1","article-title":"Minimizing ICU neurological dysfunction with dexmedetomidine\u2010 induced sleep (MINDDS): protocol for arm, placebo\u2010controlled trial","volume":"8","author":"Shelton KT","year":"2018","journal-title":"British Medical Journal Open"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008568"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/2110-5820-2-49"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc10518"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0082913"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199604000-00015"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199008000-00007"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2007.05306.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(03)00165-7"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.06.062"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2015.06.012"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2014.03.010"},{"key":"e_1_2_6_20_1","first-page":"CD010269","article-title":"Alpha\u20102 agonists for long\u2010term sedation during mechanical ventilation in critically ill patients","volume":"1","author":"Chen K","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.10.026"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182a16898"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30580-3"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188634"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201710-1995OC"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_6_28_1","unstructured":"RyanR HillS.How to GRADE the quality of the evidence. 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