ICU sedation, delirium & recovery
Effect of intensive care unit sedation strategy on patient‐reported experience: secondary mediation analysis of the A2B randomised controlled trial
Primary result · Patient-recalled experience, ICE-Q domain: awareness of surroundingsResult — go to the resultAdjusted mean difference 3.6 95% CI 1.0–6.2Authors' conclusion
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-generating findings in a subgroup of the A2B cohort do not support the use of dexmedetomidine over propofol based on patient-reported experience. Based on our findings, we advocate that a personalised approach to sedation strategies should continue to be used.
Study context
- Population
- Patients from the A2B trial who completed the Intensive Care Experience Questionnaire (ICE-Q) at 90 days post-randomisationICE-Qs completed, of 1009 (71.9%) alive at 90 days, of 1404 patients included in the primary trial analysis
- Participants
- 289 patients
- Comparison
- Sedation strategy
- Primary endpoint
- Patient-recalled experience, ICE-Q domain: awareness of surroundings
- Follow-up
- 90 days post-randomisation
Methodological detailsmediation analyses, linear regression, adjusting for potential confounders
- Mediation analyses
- Linear regression, adjusting for potential confounders
Primary result
As reported in the abstract
Adjusted mean difference
3.6
95% CI 1.0–6.2
P = 0.01
By group
Dexmedetomidine
32
median score
Propofol
28
median score
Further findings
Other ICE-Q domains (frightening memories, recall, satisfaction) · 90 days post-randomisation
- No associations were found with other ICE-Q domains
Mediation analysis of the dexmedetomidine-awareness relationship (duration of mechanical ventilation; ICU stay; days with pain behaviour, agitation and coma/delirium)
- The contribution of the five potential mediators on the dexmedetomidine-awareness relationship was small
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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