More than 50% of critically ill patients receive 1 or more sedative agents to minimize agitation and anxiety. Society of Critical Care Medicine guidelines recommend use of a first-line, nonbenzodiazepine sedative during mechanical ventilation. Dexmedetomidine is increasingly used, but variations in patients’ responses do exist. Smithburger and colleagues studied 38 adult intensive care unit (ICU) patients to examine the relationship between specific patient characteristics and the effectiveness of a continuous dexmedetomidine infusion. Findings include the following:
Sedation with dexmedetomidine was ineffective in 50% of the patients.
Successful sedation was more likely in patients with a lower severity of illness score and those with a history of antidepressant medication use.
There were no differences in the amount of narcotics, benzodiazepines, antipsychotics, or propofol between the successfully sedated and unsuccessfully sedated patients.
Further research with larger samples is needed to validate these findings.