{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:53:46Z","timestamp":1791330826910,"version":"4.3.1"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["16\/93\/01"],"award-info":[{"award-number":["16\/93\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The optimal ICU sedation strategy to improve patient\u2010reported experience is unknown. In a planned secondary analysis of the A2B randomised trial, we evaluated the effect of sedation strategy (dexmedetomidine, clonidine or propofol) on recalled patient experience at 90\u2009days post\u2010randomisation. Using mediation analyses, we explored plausible mediators of the relationship between sedation strategy and patient experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed data for all patients from A2B who completed the Intensive Care Experience Questionnaire (ICE\u2010Q) at 90\u2009days. The primary outcome was patient\u2010recalled experience, measured by the four ICE\u2010Q domain scores (awareness, frightening memories, recall, satisfaction). Sedation strategy effect was evaluated using linear regression, adjusting for potential confounders. Mediation analyses were conducted for duration of mechanical ventilation; ICU stay; and days with pain behaviour, agitation and coma\/delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1404 patients included in the primary trial analysis, 1009 (71.9%) were alive at 90\u2009days post\u2010randomisation with ICE\u2010Qs completed by 289\/1009 (28.6%). Compared with propofol, dexmedetomidine sedation was associated with higher awareness of surroundings (median score 32 vs. 28, adjusted mean difference 3.6, 95%CI 1.0\u20136.2, p\u2009=\u20090.01), but clonidine sedation had no association (difference 2.4, 95%CI \u20100.2\u20135.0, p\u2009=\u20090.07). No associations were found with other ICE\u2010Q domains. The contribution of the five potential mediators on the dexmedetomidine\u2013awareness relationship was small.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Dexmedetomidine compared with propofol sedation strategy may be associated with increased recalled awareness of surroundings, which is considered a favourable indicator of ICU experience. Together with the primary A2B trial results, which showed no effect on ventilation duration, these hypothesis\u2010generating findings in a subgroup of the A2B cohort do not support the use of dexmedetomidine over propofol based on patient\u2010reported experience. Based on our findings, we advocate that a personalised approach to sedation strategies should continue to be used.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70437","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:40:21Z","timestamp":1791330021000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of intensive care unit sedation strategy on patient\u2010reported experience: secondary mediation analysis of the\n                    <scp>A2B<\/scp>\n                    randomised controlled trial"],"prefix":"10.1111","author":[{"given":"John A.","family":"Masterson","sequence":"first","affiliation":[{"name":"Centre for Population Health Sciences, Usher Institute The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Centre for Population Health Sciences, Usher Institute The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne M.","family":"Aitken","sequence":"additional","affiliation":[{"name":"School of Health and Psychological Sciences City St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronagh","family":"Blackwood","sequence":"additional","affiliation":[{"name":"School of Medicine, Dentistry and Biomedical Sciences, Wellcome\u2010Wolfson Institute for Experimental Medicine Queen's University Belfast  Belfast Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalliopi","family":"Kydonaki","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, National and Kapodistrian University of Athens  Athens Greece"},{"name":"School of Health and Social Care Edinburgh Napier University  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrine A.","family":"McKenzie","sequence":"additional","affiliation":[{"name":"National Institute of Health and Social Care Research, Biomedical Research Centre, Southampton, Perioperative and Critical Care theme University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Parker","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Weir","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy S.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Centre for Population Health Sciences, Usher Institute The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2707-2779","authenticated-orcid":false,"given":"Nazir I.","family":"Lone","sequence":"additional","affiliation":[{"name":"Centre for Population Health Sciences, Usher Institute The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the A2B trial investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"The King's Fund.From vision to action: Making patient\u2010centred care a reality.2012.https:\/\/www.kingsfund.org.uk\/insight\u2010and\u2010analysis\/reports\/vision\u2010action\u2010making\u2010patient\u2010centred\u2010care\u2010reality(Accessed: 01 December 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