{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T16:07:58Z","timestamp":1793376478932,"version":"4.5.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0236014","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T17:35:20Z","timestamp":1594920920000},"page":"e0236014","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Different depths of sedation versus risk of delirium in adult mechanically ventilated patients: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"15","author":[{"given":"Ling","family":"Long","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichun","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haotian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heling","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8265-2947","authenticated-orcid":true,"given":"Penglin","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"issue":"2","key":"pone.0236014.ref001","first-page":"75","article-title":"Motoric subtypes of delirium","volume":"5","author":"DJ Meagher","year":"2000","journal-title":"Semin Clin Neuropsychiatry"},{"issue":"14","key":"pone.0236014.ref002","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1001\/jama.291.14.1753","article-title":"Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit","volume":"291","author":"EW Ely","year":"2004","journal-title":"JAMA"},{"issue":"2","key":"pone.0236014.ref003","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/CCM.0b013e31826ab49b","article-title":"Delirium in the cardiovascular ICU: exploring modifiable risk factors","volume":"41","author":"JA Mcpherson","year":"2013","journal-title":"Crit Care Med"},{"issue":"14","key":"pone.0236014.ref004","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1056\/NEJMoa1301372","article-title":"Long-Term Cognitive Impairment after Critical Illness","volume":"369","author":"PP Pandharipande","year":"2013","journal-title":"N Engl J Med"},{"issue":"5","key":"pone.0236014.ref005","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1056\/NEJMra1208705","article-title":"Sedation and Delirium in the Intensive Care Unit","volume":"370","author":"MC Reade","year":"2014","journal-title":"N Engl J Med"},{"issue":"6","key":"pone.0236014.ref006","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1513\/AnnalsATS.201307-232FR","article-title":"Can intensive care unit delirium be prevented and reduced?. Lessons learned and future directions","volume":"10","author":"SJ Hsieh","year":"2013","journal-title":"Ann Am Thorac Soc"},{"issue":"3","key":"pone.0236014.ref007","doi-asserted-by":"crossref","first-page":"R77","DOI":"10.1186\/cc7892","article-title":"Risk factors for delirium in intensive care patients: a prospective cohort study","volume":"13","author":"BV Rompaey","year":"2009","journal-title":"Crit Care"},{"issue":"3","key":"pone.0236014.ref008","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/s00134-012-2726-6","article-title":"Intensive care unit environment may affect the course of delirium","volume":"39","author":"IJ Zaal","year":"2013","journal-title":"Intensive Care Med"},{"issue":"12","key":"pone.0236014.ref009","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s00134-012-2678-x","article-title":"Associations of markers of inflammation and coagulation with delirium during critical illness","volume":"38","author":"TD Girard","year":"2012","journal-title":"Intensive Care Med"},{"issue":"1","key":"pone.0236014.ref010","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/CCM.0000000000000625","article-title":"A Systematic Review of Risk Factors for Delirium in the ICU","volume":"43","author":"IJ Zaal","year":"2015","journal-title":"Crit Care Med"},{"issue":"9","key":"pone.0236014.ref011","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1097\/CCM.0b013e3181a5689f","article-title":"Randomized trial of light versus deep sedation on mental health after critical illness","volume":"37","author":"MM Treggiari","year":"2009","journal-title":"Crit Care Med"},{"issue":"1","key":"pone.0236014.ref012","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4065\/mcp.2009.0469","article-title":"Sedation Depth During Spinal Anesthesia and the Development of Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Repair","volume":"85","author":"FE Sieber","year":"2010","journal-title":"Mayo Clin Proc"},{"issue":"3","key":"pone.0236014.ref013","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/CCM.0000000000002885","article-title":"Practice Patterns and Outcomes Associated With Early Sedation Depth in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis*","volume":"46","author":"RJ Stephens","year":"2018","journal-title":"Crit Care Med"},{"issue":"8","key":"pone.0236014.ref014","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/j.1399-6576.2008.01702.x","article-title":"Light vs. heavy sedation during mechanical ventilation after oesophagectomy\u2013a pilot experimental study focusing on memory","volume":"52","author":"KAM Samuelson","year":"2008","journal-title":"Acta Anaesthesiol Scand"},{"issue":"9","key":"pone.0236014.ref015","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1097\/CCM.0b013e3181a5689f","article-title":"Randomized trial of light versus deep sedation on mental health after critical illness*","volume":"37","author":"MM Treggiari","year":"2009","journal-title":"Crit Care Med"},{"issue":"9607","key":"pone.0236014.ref016","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/S0140-6736(08)60105-1","article-title":"Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial","volume":"371","author":"TD Girard","year":"2008","journal-title":"Lancet"},{"issue":"22","key":"pone.0236014.ref017","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.1001\/jama.298.22.2644","article-title":"Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial","volume":"298","author":"PP Pandharipande","year":"2007","journal-title":"JAMA"},{"issue":"9713","key":"pone.0236014.ref018","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0140-6736(09)62072-9","article-title":"A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial","volume":"375","author":"T Str\u00f8m","year":"2010","journal-title":"Lancet"},{"issue":"8","key":"pone.0236014.ref019","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1097\/CCM.0b013e31828a437d","article-title":"Early Goal-Directed Sedation Versus Standard Sedation in Mechanically Ventilated Critically Ill Patients: A Pilot Study*","volume":"41","author":"Y Shehabi","year":"2013","journal-title":"Crit Care Med"},{"key":"pone.0236014.ref020","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0","author":"JPT Higgins","year":"2011"},{"issue":"22","key":"pone.0236014.ref021","doi-asserted-by":"crossref","first-page":"2983","DOI":"10.1001\/jama.289.22.2983","article-title":"Monitoring Sedation Status Over Time in ICU Patients: Reliability and Validity of the Richmond Agitation-Sedation Scale (RASS)","volume":"289","author":"EW Ely","year":"2003","journal-title":"JAMA"},{"issue":"7","key":"pone.0236014.ref022","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1097\/00003246-199907000-00022","article-title":"Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients","volume":"27","author":"RR Riker","year":"1999","journal-title":"Crit Care Med"},{"issue":"5920","key":"pone.0236014.ref023","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1136\/bmj.2.5920.656","article-title":"Controlled sedation with alpaxalone-alphadolone","volume":"2","author":"MA Ramsay","year":"1974","journal-title":"Br Med J"},{"issue":"7","key":"pone.0236014.ref024","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1097\/00003246-199907000-00008","article-title":"Motor activity assessment scale: a valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit","volume":"27","author":"JW Devlin","year":"1999","journal-title":"Crit Care Med"},{"issue":"21","key":"pone.0236014.ref025","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","article-title":"Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU)","volume":"286","author":"EW Ely","year":"2001","journal-title":"JAMA"},{"key":"pone.0236014.ref026","volume-title":"Diagnostic and StatisticalManual of Mental Discorders (DSM-4)","author":"American Psychiatric Association","year":"1994","edition":"4"},{"issue":"9","key":"pone.0236014.ref027","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"A Stang","year":"2010","journal-title":"Eur J Epidemiol"},{"issue":"8","key":"pone.0236014.ref028","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1164\/rccm.201203-0522OC","article-title":"Early Intensive Care Sedation Predicts Long-Term Mortality in Ventilated Critically Ill Patients","volume":"186","author":"Y Shehabi","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"issue":"7","key":"pone.0236014.ref029","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.ijnurstu.2011.11.016","article-title":"Incidence and short-term consequences of delirium in critically ill patients: A prospective observational cohort study","volume":"49","author":"M van den Boogaard","year":"2012","journal-title":"Int J Nurs Stud"},{"issue":"6","key":"pone.0236014.ref030","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1097\/CCM.0b013e31827ca949","article-title":"Reducing Deep Sedation and Delirium in Acute Lung Injury Patients: A Quality Improvement Project*","volume":"41","author":"DN Hager","year":"2013","journal-title":"Crit Care Med"},{"issue":"2","key":"pone.0236014.ref031","doi-asserted-by":"crossref","first-page":"A217","DOI":"10.1097\/01.ccm.0000440107.42126.50","article-title":"Early goal directed sedation with dexmedetomidine vs standard sedatives, randomized control trial","volume":"41","author":"Y Shehabi","year":"2013","journal-title":"Crit Care Med"},{"issue":"1","key":"pone.0236014.ref032","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/2110-5820-4-14","article-title":"Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial","volume":"4","author":"AP Nassar Junior","year":"2014","journal-title":"Ann Intensive Care"},{"issue":"3","key":"pone.0236014.ref033","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1513\/AnnalsATS.201306-210OC","article-title":"Improved analgesia, sedation, and delirium protocol associated with decreased duration of delirium and mechanical ventilation","volume":"11","author":"CR Dale","year":"2014","journal-title":"Ann Am Thorac Soc"},{"issue":"1","key":"pone.0236014.ref034","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s13054-015-0929-2","article-title":"Early deep sedation is associated with decreased in-hospital and two-year follow-up survival","volume":"19","author":"F Balzer","year":"2015","journal-title":"Crit Care"},{"issue":"1","key":"pone.0236014.ref035","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s13054-015-0874-0","article-title":"Clinical effectiveness of a sedation protocol minimizing benzodiazepine infusions and favoring early dexmedetomidine: a before-after study","volume":"19","author":"LP Skrupky","year":"2015","journal-title":"Crit Care"},{"issue":"5","key":"pone.0236014.ref036","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.chest.2017.05.041","article-title":"Analgosedation practices and the impact of sedation depth on clinical outcomes among patients requiring mechanical ventilation in the emergency department: a cohort study","volume":"152","author":"RJ Stephens","year":"2017","journal-title":"Chest"},{"issue":"13","key":"pone.0236014.ref037","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1001\/jama.2017.2088","article-title":"Effect of Dexmedetomidine on Mortality and Ventilator-Free Days in Patients Requiring Mechanical Ventilation With Sepsis","volume":"317","author":"Y Kawazoe","year":"2017","journal-title":"JAMA"},{"issue":"50","key":"pone.0236014.ref038","first-page":"195","article-title":"Impact of a nursing-driven sedation protocol with criteria for infusion initiation in the surgical intensive care unit","volume":"30","author":"JB Kaplan","year":"2018","journal-title":"J Crit Care"},{"issue":"1","key":"pone.0236014.ref039","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s13613-018-0425-3","article-title":"Impact of oversedation prevention in ventilated critically ill patients: a randomized trial-the AWARE study","volume":"8","author":"B De Jonghe","year":"2018","journal-title":"Ann Intensive Care"},{"issue":"2","key":"pone.0236014.ref040","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1378\/chest.114.2.541","article-title":"The use of continuous i.v. sedation is associated with prolongation of mechanical ventilation","volume":"114","author":"MH Kollef","year":"1998","journal-title":"Chest"},{"issue":"4","key":"pone.0236014.ref041","doi-asserted-by":"crossref","first-page":"R156","DOI":"10.1186\/cc13995","article-title":"ERICC study investigators. Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study","volume":"18","author":"LM Tanaka","year":"2014","journal-title":"Crit Care"},{"issue":"1","key":"pone.0236014.ref042","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00000542-200601000-00005","article-title":"Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients","volume":"104","author":"P Pandharipande","year":"2006","journal-title":"Anesthesiology"},{"issue":"1","key":"pone.0236014.ref043","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/CCM.0b013e318192fcf9","article-title":"Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population","volume":"37","author":"MA Pisani","year":"2009","journal-title":"Crit Care Med"},{"issue":"3","key":"pone.0236014.ref044","doi-asserted-by":"crossref","first-page":"540.e1","DOI":"10.1016\/j.jcrc.2010.02.009","article-title":"Factors associated with persistent delirium after intensive care unit admission in an older medical patient population","volume":"25","author":"MA Pisani","year":"2010","journal-title":"J Crit Care"},{"issue":"10","key":"pone.0236014.ref045","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1097\/CCM.0000000000003300","article-title":"Benzodiazepine Use and Neuropsychiatric Outcomes in the ICU","volume":"46","author":"L Kok","year":"2018","journal-title":"Crit Care Med"},{"issue":"1","key":"pone.0236014.ref046","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/CCM.0b013e3182783b72","article-title":"Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit","volume":"41","author":"J Barr","year":"2013","journal-title":"Crit Care Med"},{"issue":"6","key":"pone.0236014.ref047","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1007\/s00134-016-4297-4","article-title":"Comfort and patient-centred care without excessive sedation: the eCASH concept","volume":"42","author":"JL Vincent","year":"2016","journal-title":"Intensive Care Med"},{"issue":"9","key":"pone.0236014.ref048","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation\/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU","volume":"46","author":"JW Devlin","year":"2018","journal-title":"Crit Care Med"},{"issue":"2","key":"pone.0236014.ref049","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.jcrc.2014.10.021","article-title":"Clinician perspectives on protocols designed to minimize sedation","volume":"30","author":"L Rose","year":"2015","journal-title":"J Crit Care"},{"issue":"4","key":"pone.0236014.ref050","doi-asserted-by":"crossref","first-page":"2749","DOI":"10.1378\/chest.128.4.2749","article-title":"A Prospective Study of Agitation in a Medical-Surgical ICU: Incidence, Risk Factors, and Outcomes","volume":"128","author":"S Jaber","year":"2005","journal-title":"CHEST"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0236014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T17:36:26Z","timestamp":1594920986000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0236014"}},"subtitle":[],"editor":[{"given":"Luciane Cruz","family":"Lopes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,7,16]]},"references-count":50,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0236014","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,16]]}}}