Dexmedetomidine Might Help Liberate Delirious Patients from the Ventilator

Dexmedetomidine is a sedating α-2 agonist that doesn't impair respiratory drive. In this multicenter study, investigators randomized 74 intensive care unit (ICU) patients with agitated delirium to receive either dexmedetomidine or placebo for ≤7 days. All patients were receiving mechanical ventilation and remained intubated only because lowering sedation levels to allow extubation would have been unsafe. This determination was made by treating clinicians based on objective criteria (i.e., need for mechanical restraints or sedative medications, and presence of delirium and psychomotor agitation according to standard scales).

Dexmedetomidine recipients were extubated sooner than placebo recipients (median time to extubation, 22 vs. 44 hours) a…