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The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis
Background: The practice of low vs. high sedation dosing strategy may impact the cognitive and mental health function in the intensive care unit (ICU). We aim to demonstrate that high sedation strategy will result in change of mental health function in ICU patients. Methods: We performed a systemic...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Tabriz University of Medical Sciences
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492176/ https://www.ncbi.nlm.nih.gov/pubmed/26191390 http://dx.doi.org/10.15171/jcvtr.2015.10 |
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author | Porhomayon, Jahan Joude, Philippe Adlparvar, Ghazaleh El-Solh, Ali A. Nader, Nader D. |
author_facet | Porhomayon, Jahan Joude, Philippe Adlparvar, Ghazaleh El-Solh, Ali A. Nader, Nader D. |
author_sort | Porhomayon, Jahan |
collection | PubMed |
description | Background: The practice of low vs. high sedation dosing strategy may impact the cognitive and mental health function in the intensive care unit (ICU). We aim to demonstrate that high sedation strategy will result in change of mental health function in ICU patients. Methods: We performed a systemic search and meta-analysis of medical databases in MEDLINE (from 1966 to March 2013) and EMBASE (from 1980 to March 2013), as well as the Cochrane Library using the MESH terms "Intensive Care Unit," and "Mental Health, for assessing the impact of sedation on posttraumatic stress disorder (PTSD) or anxiety/depression and delirium in the mix ICU setting including cardiac surgery patients. A total of 1216 patients were included in the final analysis. Results: We included 11 studies in the final analysis and concluded that high dose sedation strategy resulted in higher incidence of cognitive dysfunction with P value of 0.009. The result for subgroup of delirium showed P = 0.11 and PTSD/depression or anxiety of P = 0.001, Heterogeneity I2 was 64%. Overall analysis was statistically significant with a P value of 0.002. Conclusion: High sedation dosing strategy will negatively affect cognitive function in critically ill patients. Large randomized trials are needed to address cognitive dysfunction in subgroup of patients with delirium. |
format | Online Article Text |
id | pubmed-4492176 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Tabriz University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-44921762015-07-17 The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis Porhomayon, Jahan Joude, Philippe Adlparvar, Ghazaleh El-Solh, Ali A. Nader, Nader D. J Cardiovasc Thorac Res Review Article Background: The practice of low vs. high sedation dosing strategy may impact the cognitive and mental health function in the intensive care unit (ICU). We aim to demonstrate that high sedation strategy will result in change of mental health function in ICU patients. Methods: We performed a systemic search and meta-analysis of medical databases in MEDLINE (from 1966 to March 2013) and EMBASE (from 1980 to March 2013), as well as the Cochrane Library using the MESH terms "Intensive Care Unit," and "Mental Health, for assessing the impact of sedation on posttraumatic stress disorder (PTSD) or anxiety/depression and delirium in the mix ICU setting including cardiac surgery patients. A total of 1216 patients were included in the final analysis. Results: We included 11 studies in the final analysis and concluded that high dose sedation strategy resulted in higher incidence of cognitive dysfunction with P value of 0.009. The result for subgroup of delirium showed P = 0.11 and PTSD/depression or anxiety of P = 0.001, Heterogeneity I2 was 64%. Overall analysis was statistically significant with a P value of 0.002. Conclusion: High sedation dosing strategy will negatively affect cognitive function in critically ill patients. Large randomized trials are needed to address cognitive dysfunction in subgroup of patients with delirium. Tabriz University of Medical Sciences 2015 /pmc/articles/PMC4492176/ /pubmed/26191390 http://dx.doi.org/10.15171/jcvtr.2015.10 Text en © 2015 The Author(s) This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Porhomayon, Jahan Joude, Philippe Adlparvar, Ghazaleh El-Solh, Ali A. Nader, Nader D. The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis |
title | The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis |
title_full | The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis |
title_fullStr | The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis |
title_full_unstemmed | The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis |
title_short | The Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis |
title_sort | impact of high versus low sedation dosing strategy on cognitive dysfunction in survivors of intensive care units: a systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492176/ https://www.ncbi.nlm.nih.gov/pubmed/26191390 http://dx.doi.org/10.15171/jcvtr.2015.10 |
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