Dexmedetomidine vs. Propofol for Sedation During Mechanical Ventilation

Current best practice in the intensive care unit (ICU) is to use the least medication necessary to keep patients alert, interactive, and comfortable while they receive mechanical ventilation. Compared with propofol and benzodiazepines, dexmedetomidine has been associated with less delirium and lighter sedation in small studies, although larger trials have been less definitive. Bench research suggests dexmedetomidine might have anti-inflammatory properties and help with bacterial clearance.

Investigators randomized 422 patients with sepsis and respiratory failure requiring invasive mechanical ventilation to receive either dexmedetomidine or propofol for sedation. More than half of patients were on vasopressors at enrollment. Sedation was targ…