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Table 2 Study outcomes using the intention-to-treatment analysis

From: Sequential use of midazolam and dexmedetomidine for long-term sedation may reduce weaning time in selected critically ill, mechanically ventilated patients: a randomized controlled study

     

Value of pairwise comparison

1 versus 2

1 versus 3

2 versus 3

Outcome Measure

1 Group M–D

(n = 77)

2 Group M–P

(n = 78)

3 Group M

(n = 73)

P value

HR, OR, or difference (95% CI), P value

HR, OR, or difference (95% CI), P value

HR, OR, or difference (95% CI), P value

Weaning timea, median (IQR), h

25.0 (18.0–48.0)

32.0 (23.0–51.0)

49.0 (26.5–73.0)

0.028

HR = 1.10 (0.77, 1.58), P = 0.610

HR = 1.47 (1.05, 2.06), P = 0.025

HR = 1.33 (1.00, 1.78), P = 0.048

Recovery timeb, median (IQR), h

0.3 (0.0–1.5)

2.0 (1.0–4.5)

7.0 (2.0–28.0)

 < 0.001

D = − 1.8 (− 1.9, − 1.8), P < 0.001

D = − 6.5 (− 6.6, − 6.5), P < 0.001

D = − 4.7 (− 4.7, − 4.6), P < 0.001

Extubation timeb, median (IQR), h

0.5 (0.0–6.8)

3.5 (1.5–5.5)

7.8 (2.0–30.2)

 < 0.001

D = − 2.5 (− 2.5, − 2.5), P < 0.001

D = − 7.3 (− 7.3, − 7.2), P < 0.001

D = − 4.8 (− 4.8, − 4.7), P < 0.001

Sedation administration durationb, median (IQR), h

24.0 (13.3–37.5)

26.0 (20.0–47.8)

25.0 (24.0–45.0)

0.020

D = − 4.3 (− 4.3, − 4.2), P < 0.001

D = − 2.2 (− 2.2, − 2.1), P < 0.001

D = 2.1 (2.1, 2.2), P < 0.001

Percentage of times within target sedation range, %

71.4

42.9

39.2

 < 0.001

D = 28.5 (24.1, 32.9), P < 0.001

D = 32.2 (27.6, 36.8), P < 0.001

D = 3.7 (− 0.9, 8.3), P = 0.191

Successful extubation, No. (%)

70 (90.9)

73 (93.6)

65 (89.0)

0.610

NA

NA

NA

Tracheotomy, No. (%)

2 (2.6)

1 (1.3)

4 (5.5)

0.265

NA

NA

NA

Delirium, No. (%)

15 (19.5)

23 (29.5)

32 (43.8)

0.005

OR = 0.58 (0.27, 1.21), P = 0.150

OR = 0.31 (0.15, 0.63), P = 0.002

OR = 0.54 (0.27, 1.05), P = 0.069

The accumulated dose of fentanyl after randomization, median (IQR), mg

1.5 (1.0–2.5)

2.5 (1.0–4.0)

2.0 (1.0–4.0)

0.012

D = − 1.0 (− 1.0, − 1.0), P < 0.001

D = − 0.5 (− 0.6, − 0.5), P < 0.001

D = 0.5 (0.5, 0.5), P < 0.001

The average maintenance dose of sedatives c, median (IQR), mg/kg/h or μg/kg/h

0.247 (0.171–0.392)

0.767 (0.567–0.962)

0.074 (0.053–0.128)

–

–

–

–

ICU durationa, median (IQR), day

13.9 (9.9–18.4)

14.2 (9.8–18.9)

18.3 (11.7–28.7)

0.148

NA

NA

NA

Length of hospital staya, median (IQR), day

18.4 (12.5–25.5)

19.4 (14.9–34.5)

23.8 (17.3–40.3)

0.448

NA

NA

NA

ICU mortality, No. (%)

2 (2.6)

7 (9.0)

5 (6.8)

0.241

NA

NA

NA

Hospital mortality, No. (%)

2 (2.6)

7 (9.0)

5 (6.8)

0.241

NA

NA

NA

Adverse effects, No. (%)

5 (6.5)

13 (16.7)

7 (9.6)

0.116

NA

NA

NA

Hypotension, No. (%)

4 (5.2)

2 (2.6)

0 (0.0)

0.148

NA

NA

NA

Bradycardia, No. (%)

1 (1.3)

1 (1.3)

0 (0.0)

1.000

NA

NA

NA

Hypertensiond, No. (%)

0 (0.0)

9 (11.5)

5 (6.8)

0.004

0.003

0.025

0.321

Tachycardia, No. (%)

1 (1.3)

2 (2.6)

2 (2.7)

0.869

NA

NA

NA

Triglyceride, median (IQR), mmol/L

1.76 (1.15–2.24)

1.85 (1.28–2.37)

1.58 (1.11–2.46)

0.757

NA

NA

NA

  1. OR = odds ratio; HR = hazard ratio; D = difference; IQR, Interquartile Range; ICU, Intensive Care Unit; NA, not applicable
  2. aCalculated using competing risk model analysis
  3. bA total of 12 patients were excluded in this analysis, including 3 patients in group M (1 death, 1 withdrew treatment, and 1 tracheotomy), 3 patients in group M-P (1 withdrew treatment, 1 tracheotomy, and 1 disease deteriorated), and 6 patients in group M-D (1 death, 2 withdrew treatment, 1 tracheotomy, and 2 disease deteriorated). Recovery time: Time from stopping sedation to awakening. Extubation time: Time from stopping sedation to extubation
  4. cThe average dose of midazolam, propofol, or dexmedetomidine after randomization; mg/kg/h for midazolam or propofol; μg/kg/h for dexmedetomidine
  5. Weaning time: Time from randomization to extubation
  6. dAnalyzed using chi-squared test or fisher's exact test, with adjustment of significance level to 0.017 for comparisons for any two groups
  7. Sedation administration duration: Sedation administration period after randomization. ICU duration: Time from patient admission to ICU until discharge from ICU. Length of hospital stay: Time from patient screened until discharge from hospital