Volume 19 Supplement 2
Light sedation strategies and posttraumatic stress disorder: a systematic review and network meta-analysis
© Nassar Junior et al.; 2015
Published: 28 September 2015
Strategies aiming at light sedation are associated with decreased times on mechanical ventilation. However, awake or easily aroused patients may be prone to have greater prevalence of posttraumatic stress disorder. This systematic review and meta-analysis aimed to evaluate the safety of light sedation strategies in the prevalence of posttraumatic stress disorder.
We searched MEDLINE, Scopus and Web of Science from inception to November 2014 for randomized controlled trials which compared a light sedation strategy with a deeper sedation strategy and addressed posttraumatic stress disorder prevalence as a specific outcome.
Five studies fulfilled our inclusion criteria and were included in the meta-analysis. Two studies compared daily sedation interruption with usual care (92 patients), two studies compared a light sedation protocol with daily sedation interruption (47 patients) and one study compared light and deep sedation (102 patients). Compared with usual sedation care/deep sedation, neither daily interruption of sedation (OR = 0.66, 95 % CI 0.22-1.98) nor a light sedation protocol (OR = 0.90, 95 % CI 0.27-3.05) were associated with increased risks on long-term PTSD prevalence. Heterogeneity was moderate (I2 = 40 %).
Light sedation strategies seem to be safe in terms of posttraumatic stress disorder prevalence. However, the small number of included trials and patients may not be sufficient to drive strong statements. Ongoing large trials will be able to answer this question.
This article is published under license to BioMed Central Ltd. 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.