Table 2 GRADE summary of findings
Certainty assessment | No of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
No of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Dexmedetomidine | Other sedatives | Relative (95% CI) | Absolute (95% CI) | ||
All-cause mortality at longest follow-up | ||||||||||||
11 | Randomised trials | Not serious | Not serious | Not serious | Not serious | None | 154/616 (25.0%) | 189/606 (31.2%) | RR 0.83 (0.69 to 0.99) | 53 fewer per 1,000 (from 97 fewer to 3 fewer) | ⨁⨁⨁◯ High | CRITICAL |
Light sedation | ||||||||||||
7 | Randomised trials | Not serious | Not serious | Not serious | Not serious | None | 130/489 (26.6%) | 147/485 (30.3%) | RR 0.90 (0.74 to 1.09) | 30 fewer per 1,000 (from 79 fewer to 27 more) | ⨁⨁⨁◯ Moderate | CRITICAL |
Deep sedation | ||||||||||||
2 | Randomised trials | Not serious | Not serious | Not serious | Seriousa | Sample size | 17/75 (22.7%) | 26/71 (36.6%) | RR 0.61 (0.30 to 1.23) | 143 fewer per 1,000 (from 256 fewer to 84 more) | ⨁⨁⨁◯ Moderate | IMPORTANT |
APACHE II ≤20 | ||||||||||||
4 | Randomised trials | Not serious | Not serious | Not serious | Seriousc | None | 18/117 (15.4%) | 28/117 (23.9%) | RR 0.67 (0.32 to 1.42) | 79 fewer per 1,000 (from 163 fewer to 101 more) | ⨁⨁◯◯ Low | IMPORTANT |
APACHE II >20 | ||||||||||||
7 | Randomised trials | Not serious | Not serious | Not serious | Not serious | None | 136/499 (27.3%) | 161/489 (32.9%) | RR 0.85 (0.70 to 1.02) | 49 fewer per 1,000 (from 99 fewer to 7 more) | ⨁⨁⨁⨁ High | CRITICAL |
Dexmedetomidine vs Propofol | ||||||||||||
9 | Randomised trials | Not serious | Not serious | Not serious | Not serious | None | 145/553 (26.2%) | 164/544 (30.1%) | RR 0.89 (0.74 to 1.07) | 33 fewer per 1,000 (from 78 fewer to 21 more) | ⨁⨁⨁⨁ High | CRITICAL |
Dexmedetomidine vs other sedatives | ||||||||||||
2 | Randomised trials | Not serious | Not serious | Not serious | Not serious | Sample size | 9/63 (14.3%) | 25/62 (40.3%) | RR 0.36 (0.18 to 0.70) | 258 fewer per 1,000 (from 331 fewer to 121 fewer) | ⨁⨁◯◯ Low - | IMPORTANT |