Table 4 Summary of findings and GRADE assessment for priority outcomes

ICU-acquired infection

3246 (3RCTs; 3 QEs)

OR 0.92 (0.72 to 1.18)

⊕⊕⊝⊝

Low^a,b,c

Downgraded two levels due to inconsistency and imprecision

VAP

3246 (3RCTs; 3 QEs)

OR 0.96 (0.71 to 1.3)

⊕⊕⊝⊝

Low^a,b,c

Downgraded two levels due to inconsistency and imprecision

CAUTI

3082 (3RCTs; 2 QEs)

OR 0.97 (0.52 to 1.8)

⊕⊕⊝⊝

Low^a,b,c

Downgraded two levels due to inconsistency and imprecision

CRBSI

3082 (3RCTs; 2 QEs)

OR 1.15 (0.72 to 1.84)

⊕⊕⊝⊝

Low^a,b,c

Downgraded two levels due to inconsistency and imprecision

Delirium

2985 (4RCTs; 5 QEs)

OR 0.4 (0.25 to 0.63)

⊕⊕⊕⊝

Moderate^a,b,c

Downgraded one level due to inconsistency

Mortality

2727 (2RCTs; 2 QEs)

OR 1.03 (0.83 to 1.28)

⊕⊕⊕⊝

Moderate^a,b,c

Downgraded one levels due to inconsistency

ICU length of stay

2972 (1RCTs; 6 QEs)

SMD − 0.81 (− 1.3 to − 0.32)

⊕⊕⊝⊝

Low^c

Downgraded two levels due to risk of bias, and indirectness

Anxiety

311 (1RCTs; 1 QEs)

SMD − 2.39 (− 5.03 to 0.25)

⊕⊕⊝⊝

Low^a,b

Downgraded two levels due to inconsistency and imprecision

Depression

311 (1RCTs; 1 QEs)

SMD − 2.1 (− 3.22 to − 0.97)

⊕⊕⊝⊝

Low^a,b

Downgraded two levels due to inconsistency and imprecision