Related Experiment Video
Updated: Sep 11, 2025
Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor
Published on: September 29, 2020
Evaluation of Objective Sedation Monitoring Practices in Critically Ill Adult Patients: A Systematic Review and
Natalia Jaworska1,2,3, Areej Hezam1, Thérèse Poulin1,4
1Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
Objectives:
To conduct a systematic review and meta-analysis to determine if objective sedation monitoring practices reduce duration of mechanical ventilation and other clinical and healthcare utilization outcomes in critically ill adult patients.
Data Sources:
Ovid MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Library and PROSPERO, and the grey literature.
Study Selection:
Observational or interventional original research studies, conducted in adult critically ill patients undergoing invasive mechanical ventilation, evaluating any objective sedation monitoring practice (e.g., electroencephalography [EEG]), and reporting on duration of mechanical ventilation or other secondary outcomes (e.g., length of stay) were included.
Data Extraction:
Meta-analysis was performed for pooled estimates of the primary outcome and each individual secondary outcome using random-effects modeling.
Data Synthesis:
Twenty studies (3410 patients) were included with 15 studies evaluating processed EEG monitoring, 2 evaluating EEG monitoring, and 3 evaluating processed facial electromyography (EMG). Processed EEG was not associated with reduced duration of mechanical ventilation (standardized mean difference [SMD] -0.33; 95% CI, -0.91 to 0.25; I2 = 84.4%). Secondary outcomes of processed EEG monitoring showed decreased hospital length of stay (days) (SMD -0.89; 95% CI, -1.17 to -0.62; I2 = 13.4%), reduced total sedative dose (reported in propofol equivalents, mg) (SMD -1.29; 95% CI, -2.27 to -0.31; I2 = 96.6%), and reduced total opioid dose (reported in morphine equivalents, mg) (SMD -0.40; 95% CI, -0.76 to -0.04; I2 = 77.0%). Processed facial EMG was associated with an increased risk of adverse events (risk ratio 1.40; 95% CI, 1.03-1.90; I2 = 0.00%). Risk of bias was serious for 65% (n = 13/20) of included studies.
Conclusions:
Processed EEG monitoring is not associated with reduced duration of mechanical ventilation but may be associated with reduced sedative and opioid exposure and decreased hospital length of stay. Processed facial EMG monitoring may be associated with increased adverse events.
More Related Videos
06:04Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
07:54Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Related Concept Videos
01:22Stages of General Anesthesia
01:24Parenteral Anesthetics: Overview
01:23Sedatives and Hypnotics: Overview
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...