Duration of mechanical ventilation

Method

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 on the edge.

The method is part of the endpoint identity. Studies measuring the same quantity by a different method are held as separate endpoints.

Notes

Its near-miss is CAT:outcome/icu-length-of-stay, strongly correlated with it and almost always reported in the same table. They end at different events: ventilator time ends at extubation, ICU time continues through weaning, delirium and monitoring, and sedation or early-mobilisation practice moves one without the other. Note separately that raw duration and ventilator-free days are NOT the same endpoint and their SIGNS ARE OPPOSITE - ventilator-free days improve by RISING - so a review reporting the latter must not be mapped here.

Findings

2 findings from 2 compounds, strongest first.

• methylene blue — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.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).”

  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:38216185

• melatonin — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.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.”

  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:41954764