The Role of Dexmedetomidine for Sedation in Critically Ill Adults - Abstract
Management of pain, agitation, and delirium in mechanically ventilated patients is one of the foundations of therapy in the intensive care unit (ICU). Dexmedetomidine is a selective, centrally-acting ?2 adrenergic receptor agonist with sedative, analgesic, and anxiolytic properties. Pertinent literature regarding the safety and efficacy of dexmedetomidine in mechanically (invasive and non-invasive) ventilated ICU patients is reported. In the mixed medical-surgical population, dexmedetomidine is an appropriate sedative to maintain mild to moderate sedation and has been associated with shorter durations of mechanical ventilation and decreased delirium prevalence vs. benzodiazepine-based sedation. In the post-operative cardiac surgery
population, dexmedetomidine may decrease the incidence and/or duration of post-operative delirium as compared to other sedation strategies. More well-designed clinical trials are needed to determine dexmedetomidine efficacy and safety in other ICU populations (i.e. neurocritical care). Preliminary data indicates dexmedetomidine can be safely utilized to facilitate non-invasive ventilation in patients intolerant to such therapy and may be associated with improved clinical outcomes. Bradycardia is the most common reported adverse effect but has not been associated with increased interventions.