Outcomes | № of participants (studies) Follow-up | Certainty of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects | |
---|---|---|---|---|---|
Risk with no infusion (but intermittent as needed NMBA)* | Risk difference with an infusion of neuromuscular blockade | ||||
Hospital mortality subgroup (compared to light sedation) | 1006 (1 RCT) | ⨁⨁⨁◯ Moderatea,b | RR 0.99 (0.86 to 1.15) | 428 per 1000 | 4 fewer per 1000 (60 fewer to 64 more) |
Hospital mortality subgroup (compared to deep sedation) | 431 (3 RCTs) | ⨁⨁◯◯ Lowb,c | RR 0.72 (0.58 to 0.91) | 471 per 1000 | 132 fewer per 1000 (198 fewer to 42 fewer) |
Mortality–28-day mortality (pooled for all trials) | 1598 (7 RCTs)d | ⨁⨁◯◯ Lowb,e,f | RR 0.74 (0.56 to 0.98) | 369 per 1000 | 96 fewer per 1000 (162 fewer to 7 fewer) |
Mortality–hospital/90-day mortality (pooled for all trials) | 1478 (5 RCTs) | ⨁⨁◯◯ Lowb,g | RR 0.78 (0.60 to 1.01) | 437 per 1000 | 96 fewer per 1000 (175 fewer to 4 more) |
Mental health at 6 months | 267 (1 RCT) | ⨁⨁◯◯ Lowb,h | RR 1.03 (0.69 to 1.55) | 254 per 1000 | 8 more per 1000 (79 fewer to 140 more) |
Cognitive function (MOCA scores) | 287 (1 RCT) | ⨁⨁◯◯ Lowi,j | – | The mean cognitive Function (MOCA Scores) was 22.8 points | MD 0.6 points lower (1.71 lower to 0.51 higher) |
Quality of life | 401 (1 RCT)k | ⨁⨁◯◯ Lowb,l,m | – | The mean quality of life was 0.73 units | MD 0.07 units lower (0.15 lower to 0.01 higher) |
Adverse events | 1437 (4 RCTs) | ⨁⨁◯◯ Lowb,n | RR 1.63 (0.98 to 2.72) | 31 per 1000 | 19 more per 1000 (1 fewer to 53 more) |
ICU-acquired weakness | 885 (4 RCTs) | ⨁⨁⨁◯ Moderateb,o | RR 1.16 (0.98 to 1.37) | 346 per 1000 | 55 more per 1000 (7 fewer to 128 more) |
Hospital/90-day mortality (subgroup of patients with ARDS and P/F > 100) | 542 (4 RCTs) | ⨁⨁◯◯ Lowb,p,q | RR 0.87 (0.71 to 1.06) | 444 per 1000 | 58 fewer per 1000 (129 fewer to 27 more) |
Hospital/90-day mortality (subgroup of patients with ARDS and P/F≤100) | 895 (4 RCTs) | ⨁⨁◯◯ Lowb,r,s | RR 0.95 (0.82 to 1.11) | 427 per 1000 | 21 fewer per 1000 (77 fewer to 47 more) |
Hospital/90-day mortality (sensitivity analysis using ROSE late use of NMBA) | 975 (5 RCTs) | ⨁◯◯◯ Very lowb,h,t | RR 0.78 (0.57 to 1.06) | 431 per 1000 | 95 fewer per 1000 (185 fewer to 26 more) |
Barotrauma | 1437 (4 RCTs) | ⨁⨁⨁◯ Moderateb,u | RR 0.55 (0.35 to 0.85) | 73 per 1000 | 33 fewer per 1000 (47 fewer to 11 fewer) |
Ventilator-free days at 28 days | 1487 (5 RCTs) | ⨁⨁◯◯ Lowb,v,w | – | The mean ventilator-free days at 28 days was 14 days | MD 0.72 days more (0.44 fewer to 1.88 more) |
PO2/FiO2 post-randomization–PO2/FiO2 at 24 h post-randomization | 1267 (4 RCTs) | ⨁⨁◯◯ Lowb,x,y | – | The median PO2/FiO2 post-randomization -PO2/FiO2 at 24 h post-randomization was 120 | MD 7.76 higher (3.74 lower to 19.27 higher) |
PO2/FiO2 post-randomization–PO2/FiO2 at 72 h post-randomization | 1011 (4 RCTs) | ⨁⨁◯◯ Lowb,x,z | – | The mean pO2/FiO2 post-randomization -PO2/FiO2 at 72 h post-randomization was 100 | MD 15.21 higher (1.9 higher to 28.52 higher) |