A New Approach to Sedation in the ICU

Sedatives, primarily γ-aminobutyric acid (GABA) agonists such as propofol and benzodiazepines, are commonly given to intensive care unit patients to provide comfort but are associated with respiratory depression and delirium. In an international clinical trial, researchers assessed whether these hazards were less likely with use of a novel sedative, dexmedetomidine (Precedex). In a manufacturer-supported study, this α₂-adrenoreceptor agonist, which is approved for short-term use at low doses, was used for up to 30 days at up to double the approved dose.

A total of 366 mechanically ventilated ICU patients were randomized to standardized infusion doses of dexmedetomidine or midazolam; adverse events were assessed from enrollment to 30 days aft…