Author(s): Mark E. Nunnally, Karin Neufeld Date: Question: An an alpha-2 agonist (e.g., dexmedetomidine) compared to no such strategy in critically ill adults WITH delirium Setting: Intensive care unit Bibliography: Reade MC, et. al. JAMA 2016, PMID: 26975647 Quality assessment of patients Effect № Quality Importance an an alpha-2 of Study Relative Absolute № Risk of bias Inconsistency Indirectness Imprecision Other considerations agonist (e.g., no such strategy studies design (95% CI) (95% CI) dexmedetomidine) In-hospital mortality 1 randomised serious a not serious serious b very serious none 2/39 (5.1%) 0/32 (0.0%) % Difference 5.1 -- per 1,000 CRITICAL trials (-1.8 to 12.1) (from -- to --) VERY LOW Hospital length of stay 1 randomised serious a not serious serious b serious c none 39 32 - median 0 days IMPORTANT trials (3 lower to 3 higher) VERY LOW ICU length of stay 1 randomised serious a not serious serious b serious c none 39 32 - median 1 days fewer IMPORTANT trials (2.1 fewer to 0.1 more) VERY LOW Duration of CAM positive delirium 1 randomised serious a not serious serious b not serious none 39 32 - median 24 hours lower IMPORTANT trials (41 lower to 6 lower) LOW Ventilator-free days (follow up: 7 days)
Author(s): Mark E. Nunnally, Karin Neufeld Date: Question: An an alpha-2 agonist (e.g., dexmedetomidine) compared to no such strategy in critically ill adults WITH delirium Setting: Intensive care unit Bibliography: Reade MC, et. al. JAMA 2016, PMID: 26975647 Quality assessment № of patients Effect Quality Importance № of studies Study design Risk of bias Inconsistency Indirectness Imprecision Other considerations an an alpha-2 agonist (e.g., dexmedetomidine) no such strategy Relative (95% CI) Absolute (95% CI) In-hospital mortality 1 randomised trials serious a not serious serious b very serious none 2/39 (5.1%) 0/32 (0.0%) % Difference 5.1 (-1.8 to 12.1) -- per 1,000 (from -- to --) VERY LOW CRITICAL Hospital length of stay 1 randomised trials serious a not serious serious b serious c none 39 32 - median 0 days (3 lower to 3 higher) VERY LOW IMPORTANT ICU length of stay 1 randomised trials serious a not serious serious b serious c none 39 32 - median 1 days fewer (2.1 fewer to 0.1 more) VERY LOW IMPORTANT Duration of CAM positive delirium 1 randomised trials serious a not serious serious b not serious none 39 32 - median 24 hours lower (41 lower to 6 lower) LOW IMPORTANT Ventilator-free days (follow up: 7 days)
CCM_46_9_2018_06_08_DEVLIN_CCMED-D-18-00069_SDC26.docx