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Multiple recent trials have yielded mixed results on whether dexmedetomidine for sedation during mechanical ventilation prevents delirium. Interestingly, however, one such study suggested markedly lower mortality in septic patients who were sedated with dexmedetomidine (Crit Care 2010; 14:R38). To study this potential effect, Japanese investigators randomized 201 mechanically ventilated sepsis patients (mean age, 69) to sedation with or without dexmedetomidine. The patients in the control arm received either propofol or midazolam, based on local practice and physician preference.
No significant differences were found between the groups at 28 days in mortality or number of ventilator-free days. Although patients treated with dexmedetomidine w…