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Dexmedetomidine vs Other Sedatives in Critically Ill Mechanically Ventilated Adults: A Systematic Review and Meta-Analysis of Randomized Trials

By Currents Editor posted 07-18-2022 09:40


Intensive Care Medicine (06/01/22) DOI: 10.1007/s00134-022-06712-2
Lewis, Kimberley; Alshamsi, Fayez; Carayannopoulos, Kallirroi Laiya; et al.


A recent study highlights the benefits of dexmedetomidine for mechanically ventilated adults. According to the data, use of dexmedetomidine compared with other sedatives led to a lower risk of delirium and a modest reduction of mechanical ventilation and ICU stay, although the risk for bradycardia and hypotension increased. The systematic review — which involved a search of MEDLINE, EMBASE, CENTRAL,, and the World Health Organization International Clinical Trials Registry Platform — identified 77 randomized trials (n = 11,997) comparing dexmedetomidine to other sedatives for mechanically ventilated adults in the ICU. With a relative risk of 0.67, the risk of delirium with dexmedetomidine was lower compared with other sedatives, while the mean differences for the length of mechanical ventilation and ICU stay were 1.8 hours and 0.32 days, respectively. The risk of bradycardia increased with dexmedetomidine (RR 2.39), as did the risk of hypotension (RR 1.32).


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