Endpoint

Duration of mechanical ventilation

CAT:outcome/mechanical-ventilation-durationreported in days5 findings from 5 compounds

What moved it

5 findings · 5 compounds · 2 null · by evidence strength

Compound	Direction	Findings	Strongest evidence
all-trans-retinol	no effect	1	Evidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.
melatonin	down	1	Evidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.
methylene blue	down	1	Evidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.
sodium hydrogencarbonate	up	1	Evidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.
azithromycin	no effect	1	Evidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.

Reported to move it

3 findings

methylene blue — decreases
ModerateEvidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.Finding
“The results showed that compared with placebo, MB reduced the duration of mechanical ventilation during hospitalisation in patients with distributive shock (MD: −0.68; 95% CI −1.23 to −0.14; p=0.01; I2=0%; online supplemental figure S3).”
Quoted verbatim from Effect of methylene blue on outcomes in patients with distributive shock: a meta-analysis of randomised controlled trials..
Study

meta-analysis
Population

adults with distributive shock (septic shock, vasoplegic syndrome, ischaemia-reperfusion injury); secondary endpoint; 3 trials
Effect -0.68 mean difference, 95% CI -1.23 to -0.14
Effect of methylene blue on outcomes in patients with distributive shock: a meta-analysis of randomised controlled trials.2024PMID:38216185Permalink
melatonin — decreases
ModerateEvidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.Finding
“However, melatonin group demonstrated significantly lower serum HMGB-1 and NT-pro-BNP concentrations along with shorter duration of MV and less need for oxygen therapy and shorter length of NICU stay compared to control group.”
Quoted verbatim from Melatonin effects on the left ventricular function in neonates with persistent pulmonary hypertension..
Study

RCT
Dose

Oral melatonin 10 mg/kg/day for five doses, started within the first 24 h; melatonin tablets crushed, suspended in 5 mL normal saline and given by orogastric tube, in addition to standard care
Population

Neonates of at least 36 weeks' gestation with persistent pulmonary hypertension of the newborn (PPHN), neonatal intensive care unit, Tanta University Hospitals, Egypt; n=80 randomised and analysed (40 melatonin plus standard care, 40 placebo plus standard care); duration of mechanical ventilation was a pre-specified SECONDARY clinical outcome (primary outcome was LV function at end of therapy, with LV-GLS the principal endpoint); open to clinicians, outcome assessors blinded
Melatonin effects on the left ventricular function in neonates with persistent pulmonary hypertension.2026PMID:41954764Permalink
sodium hydrogencarbonate — increases
ModerateEvidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.Finding
“However, SBIC was associated with significant increases in the duration of ventilation (WMD = 0.64 hours; 95% CI = 0.16 to 1.11 hours; P = 0.008; Figure 6), ICU length of stay (WMD = 2.06 days; 95% CI = 0.54 to 3.58 days; P = 0.008; Figure 7), and incidence of alkalemia (RR = 2.21; 95% CI = 1.42 to 3.42; P < 0.001; Additional file 4).”
Quoted verbatim from Sodium bicarbonate in the prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis..
Study

meta-analysis
Dose

intravenous bolus plus continuous infusion, regimens varied across trials
Population

Adults undergoing cardiac surgery with cardiopulmonary bypass, most with pre-existing renal impairment or at risk of acute kidney injury; secondary endpoint pooled from four randomized trials
Effect 0.64 mean difference, 95% CI 0.16 to 1.11
Sodium bicarbonate in the prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis.2014PMID:25212718Permalink

Measured, no effect detected

2 findings

all-trans-retinol — no detected effect on
ModerateEvidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.FindingNull result
“Oral vitamin A supplementation did not significantly affect mechanical ventilation duration (MD, -1.07 days; 95% CI, -2.98 to 0.83 days), oxygen requirement at 36 weeks PMA (RR, 0.65; 95% CI, 0.33 to 1.31), or moderate-to-severe BPD at 36 weeks PMA (RR, 0.53; 95% CI, 0.07 to 4.17).”
Quoted verbatim from Oral vitamin A supplementation in preterm infants to improve health outcomes: A systematic review and meta-analysis..
Study

meta-analysis
Population

Preterm infants; four randomised trials of oral vitamin A versus placebo
Effect -1.07 mean difference, 95% CI -2.98 to 0.83
Oral vitamin A supplementation in preterm infants to improve health outcomes: A systematic review and meta-analysis.2022PMID:35377893Permalink
azithromycin — no detected effect on
Very limitedEvidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.FindingNull result
“The composite of BPD or death (RR: 0.95; 95% CI: 0.83-1.10; p = 0.53; I2 = 50.2%), BPD (RR: 0.98; 95% CI: 0.83-1.15; p = 0.77; I2 = 38.1%), death (RR: 0.88; 95% CI: 0.66-1.19; p = 0.41; I2 = 0%), NEC (RR: 0.94; 95% CI: 0.69-1.26; p = 0.67; I2 = 0%), IVH (RR: 1.22; 95% CI: 0.89-1.68; p = 0.22; I2 = 3.5%), RoP (RR: 1.35; 95% CI: 0.43-4.28; p = 0.61; I2 = 76.3%), duration of mechanical ventilation (MD: 0.13; 95% CI: -1.35 to 1.60; p = 0.87; I2 = 0%), and postnatal corticosteroid requirement (RR: 0.84; 95% CI: 0.64-1.08; p = 0.18; I2 = 34.5%) were similar between the groups.”
Quoted verbatim from Azithromycin for Prevention of Bronchopulmonary Dysplasia and Other Neonatal Adverse Outcomes in Preterm Infants: An Updated Systematic Review and Meta-Analysis..
Study

meta-analysis
Population

preterm infants (meta-analysis of 6 RCTs, 1,360 infants; azithromycin vs placebo, whole population not restricted by Ureaplasma status)
Effect 0.13 mean difference, 95% CI -1.35 to 1.6
Azithromycin for Prevention of Bronchopulmonary Dysplasia and Other Neonatal Adverse Outcomes in Preterm Infants: An Updated Systematic Review and Meta-Analysis.2026PMID:40795809Permalink

How it is measured

Elapsed time from initiation of invasive mechanical ventilation to successful extubation without reintubation within the trial stated window, reported in hours or days. The censoring rule for patients who die while ventilated is recorded with each finding.

Measured, not recorded

Subject: duration of mechanical ventilation
Measurements: 18 measurements
Recorded as a finding: No

Show what was measured

Duration of mechanical ventilation
SMD -0.168 (95% CI -0.447 to 0.111), p=0.237
The results of the meta-analysis show that the early use of caffeine did not significantly reduce the duration of mechanical ventilation as a continuous variable (standard mean difference, -0.168; 95% CI, -0.447 to 0.111; P=0.237,.
PMID:26713059 · one of two readings recorded this
duration of mechanical ventilation
decreases, p = 0.02
mechanical ventilation duration (MD -1.56 days, 95% CI -2.88, -0.24, p = 0.02)
PMID:28361751 · one of two readings recorded this
duration of mechanical ventilation
decreases
However, it resulted in fewer cases of extubation failure, apnoeas and bronchopulmonary dysplasia (RR: 0.76; 95% CI: 0.60-0.96; studies = 4) and shorter duration of mechanical ventilation
PMID:30242903 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.94
Duration of mechanical ventilation (days) | 6 (3–12) [n = 23] | 7 (3–8) [n = 24] | − 1 (− 3 to 3) | 0.94
PMID:32780166 · one of two readings recorded this
duration of mechanical ventilation
decreases
Length of MV was significantly higher in the control group than that of the glutamine group.
PMID:33222464 · one of two readings recorded this
duration of mechanical ventilation
decreases, MD -1.48, 95% CI -2.43 to -0.52 (glucocorticoid)
Glucocorticoid shortened the duration of mechanical ventilation (MD - 1.48, 95% CI - 2.43 to - 0.52).
PMID:34349184 · one of two readings recorded this
duration of mechanical ventilation
no effect, MD -0.02 days, 95% CI -0.07 to 0.02, n = 1387
Not recorded as a finding: pooled across melatonin and ramelteon trials without a melatonin-only subgroup estimate; also no CAT:outcome match for this pooled figure's population
There was no difference in the duration of MV between the melatonin and placebo groups (MD, −0.02; 95% CI, −0.07 − 0.02; I2 = 33%).
PMID:36316858 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.111
Duration of MV (h), mean ± SD | 115.0 ± 268.9 | 76.8 ± 151.3 | 149.4 ± 339.8 | 0.111
PMID:36440551 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.36, n = 106
Duration of mechanical ventilation, median (IQR),† d | 7.5 (4.5 to 11.5) | 6 (3 to 10) | 0.36
PMID:36870070 · one of two readings recorded this
duration of mechanical ventilation
decreases, MD -0.68 (95% CI -1.23 to -0.14), p = 0.01
Not recorded as a finding: near-miss to the mechanical-ventilation-duration node; censoring rule for patients who die while ventilated not stated
The results showed that compared with placebo, MB reduced the duration of mechanical ventilation during hospitalisation in patients with distributive shock (MD: −0.68; 95% CI −1.23 to −0.14; p=0.01; I2=0%; online supplemental figure S3).
PMID:38216185 · one of two readings recorded this
duration of mechanical ventilation
no effect, p = 0.5, n = 108
Duration of mechanical ventilation in days | 3 (2 - 7) | 4.5 (2 - 7.5) | - | 0.5
PMID:38656078 · one of two readings recorded this
duration of mechanical ventilation
no effect, MD -1.82 days, 95% CI -5.06 to 1.41, n = 586
The use of HAT regimen was not associated with changes in the duration of mechanical ventilation compared to standard sepsis care and/or placebo (MD -1.82 days, 95% CI: -5.06-1.41; see Fig. 5b) based on 4 RCTs (N = 586).
PMID:38870923 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.515
Duration of mechanical ventilation (h), median (IQR) | 4.5 (1.1, 14.1) | 4 (0, 13.8) | 0.515
PMID:40290059 · one of two readings recorded this
duration of mechanical ventilation
no effect, p = 0.085, n = 38
Duration of MV, median (IQR), h | 326 (223–383) | 250 (160–370) | 339 (233–470) | 0.085
PMID:40974583 · one of two readings recorded this
Duration of mechanical ventilation
no effect, MD -0.84 h; 95% CI -1.93 to 0.24, p = 0.128, n = 318
Not recorded as a finding: outcome node exists (mechanical-ventilation-duration) but the finding sentence gives the estimate without naming the endpoint itself, splitting the endpoint name from the result across two sentences; not self-supporting as a claim
The random-effects meta-analysis was not significant overall (MD − 0.84 h; 95% CI − 1.93 to 0.24; p = 0.1280; low certainty) with substantial heterogeneity (I² = 74.3%).
PMID:41578281 · one of two readings recorded this
duration of mechanical ventilation
MD -0.84 h (95% CI -1.93 to 0.24), p = 0.128, n = 318
The random-effects meta-analysis was not significant overall (MD − 0.84 h; 95% CI − 1.93 to 0.24; p = 0.1280; low certainty) with substantial heterogeneity (I² = 74.3%).
PMID:41578281 · one of two readings recorded this
duration of mechanical ventilation
decreases, n = 80
However, melatonin group demonstrated significantly lower serum HMGB-1 and NT-pro-BNP concentrations along with shorter duration of MV and less need for oxygen therapy and shorter length of NICU stay compared to control group.
PMID:41954764 · one of two readings recorded this
duration of mechanical ventilation
no effect
Data from 3 studies assessing the duration of mechanical ventilation showed no significant difference between groups (MD = 0.79 days; 95% CI: −2.87 to 4.44; Table 3)
PMID:42780769 · one of two readings recorded this

Sources cited

5 papers

Subject: duration of mechanical ventilation
Findings: 5
Papers: 5

Compound

Direction

Findings

Strongest evidence

all-trans-retinol

no effect

melatonin

down

methylene blue

down

sodium hydrogencarbonate

azithromycin

no effect

Measured, not recorded

Subject

duration of mechanical ventilation

Measurements

18 measurements

Recorded as a finding

Show what was measured

Duration of mechanical ventilation
SMD -0.168 (95% CI -0.447 to 0.111), p=0.237
The results of the meta-analysis show that the early use of caffeine did not significantly reduce the duration of mechanical ventilation as a continuous variable (standard mean difference, -0.168; 95% CI, -0.447 to 0.111; P=0.237,.
PMID:26713059 · one of two readings recorded this
duration of mechanical ventilation
decreases, p = 0.02
mechanical ventilation duration (MD -1.56 days, 95% CI -2.88, -0.24, p = 0.02)
PMID:28361751 · one of two readings recorded this
duration of mechanical ventilation
decreases
However, it resulted in fewer cases of extubation failure, apnoeas and bronchopulmonary dysplasia (RR: 0.76; 95% CI: 0.60-0.96; studies = 4) and shorter duration of mechanical ventilation
PMID:30242903 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.94
Duration of mechanical ventilation (days) | 6 (3–12) [n = 23] | 7 (3–8) [n = 24] | − 1 (− 3 to 3) | 0.94
PMID:32780166 · one of two readings recorded this
duration of mechanical ventilation
decreases
Length of MV was significantly higher in the control group than that of the glutamine group.
PMID:33222464 · one of two readings recorded this
duration of mechanical ventilation
decreases, MD -1.48, 95% CI -2.43 to -0.52 (glucocorticoid)
Glucocorticoid shortened the duration of mechanical ventilation (MD - 1.48, 95% CI - 2.43 to - 0.52).
PMID:34349184 · one of two readings recorded this
duration of mechanical ventilation
no effect, MD -0.02 days, 95% CI -0.07 to 0.02, n = 1387
Not recorded as a finding: pooled across melatonin and ramelteon trials without a melatonin-only subgroup estimate; also no CAT:outcome match for this pooled figure's population
There was no difference in the duration of MV between the melatonin and placebo groups (MD, −0.02; 95% CI, −0.07 − 0.02; I2 = 33%).
PMID:36316858 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.111
Duration of MV (h), mean ± SD | 115.0 ± 268.9 | 76.8 ± 151.3 | 149.4 ± 339.8 | 0.111
PMID:36440551 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.36, n = 106
Duration of mechanical ventilation, median (IQR),† d | 7.5 (4.5 to 11.5) | 6 (3 to 10) | 0.36
PMID:36870070 · one of two readings recorded this
duration of mechanical ventilation
decreases, MD -0.68 (95% CI -1.23 to -0.14), p = 0.01
Not recorded as a finding: near-miss to the mechanical-ventilation-duration node; censoring rule for patients who die while ventilated not stated
The results showed that compared with placebo, MB reduced the duration of mechanical ventilation during hospitalisation in patients with distributive shock (MD: −0.68; 95% CI −1.23 to −0.14; p=0.01; I2=0%; online supplemental figure S3).
PMID:38216185 · one of two readings recorded this
duration of mechanical ventilation
no effect, p = 0.5, n = 108
Duration of mechanical ventilation in days | 3 (2 - 7) | 4.5 (2 - 7.5) | - | 0.5
PMID:38656078 · one of two readings recorded this
duration of mechanical ventilation
no effect, MD -1.82 days, 95% CI -5.06 to 1.41, n = 586
The use of HAT regimen was not associated with changes in the duration of mechanical ventilation compared to standard sepsis care and/or placebo (MD -1.82 days, 95% CI: -5.06-1.41; see Fig. 5b) based on 4 RCTs (N = 586).
PMID:38870923 · one of two readings recorded this
Duration of mechanical ventilation
no effect, p = 0.515
Duration of mechanical ventilation (h), median (IQR) | 4.5 (1.1, 14.1) | 4 (0, 13.8) | 0.515
PMID:40290059 · one of two readings recorded this
duration of mechanical ventilation
no effect, p = 0.085, n = 38
Duration of MV, median (IQR), h | 326 (223–383) | 250 (160–370) | 339 (233–470) | 0.085
PMID:40974583 · one of two readings recorded this
Duration of mechanical ventilation
no effect, MD -0.84 h; 95% CI -1.93 to 0.24, p = 0.128, n = 318
Not recorded as a finding: outcome node exists (mechanical-ventilation-duration) but the finding sentence gives the estimate without naming the endpoint itself, splitting the endpoint name from the result across two sentences; not self-supporting as a claim
The random-effects meta-analysis was not significant overall (MD − 0.84 h; 95% CI − 1.93 to 0.24; p = 0.1280; low certainty) with substantial heterogeneity (I² = 74.3%).
PMID:41578281 · one of two readings recorded this
duration of mechanical ventilation
MD -0.84 h (95% CI -1.93 to 0.24), p = 0.128, n = 318
The random-effects meta-analysis was not significant overall (MD − 0.84 h; 95% CI − 1.93 to 0.24; p = 0.1280; low certainty) with substantial heterogeneity (I² = 74.3%).
PMID:41578281 · one of two readings recorded this
duration of mechanical ventilation
decreases, n = 80
However, melatonin group demonstrated significantly lower serum HMGB-1 and NT-pro-BNP concentrations along with shorter duration of MV and less need for oxygen therapy and shorter length of NICU stay compared to control group.
PMID:41954764 · one of two readings recorded this
duration of mechanical ventilation
no effect
Data from 3 studies assessing the duration of mechanical ventilation showed no significant difference between groups (MD = 0.79 days; 95% CI: −2.87 to 4.44; Table 3)
PMID:42780769 · one of two readings recorded this