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Dexmedetomidine raises number of ventilator-free hours

Patients on mechanical ventilation who received dexmedetomidine improved their number of ventilator-free hours compared with patients who received placebo, according to research.

“Among patients with agitated delirium receiving mechanical ventilation in the ICU, the addition of dexmedetomidine to standard care compared with standard care alone (placebo) resulted in more ventilator-free hours at 7 days,” Michael C. Reade, DPhil, FCICM, from the University of Queensland, Health Sciences Building, Herston in Queensland, Australia, and colleagues wrote in a study. “The findings support the use of dexmedetomidine in patients such as these.”

Reade and colleagues evaluated 71 patients (mean age 57 years) from 15 intensive care units across Australia and New Zealand between May 2011 and December 2013, according to the abstract. Patients were randomized to receive dexmedetomidine (39 patients) at a rate of 0.5 μg/kg/h or placebo (32 patients).

The researchers found that there was an increase in ventilator-free hours at 7 days in the dexmedetomidine group (median 144.8 hours) compared with the placebo (127.5 hours) group (median difference = 17.0 hours 95% CI, 4-33.2 hours; P = 0.01). Further, patients in the dexmedetomidine group showed a reduced time to extubation (21.9 hours) compared with the placebo (44.3 hours) group (median difference = 19,5 hours; 95% CI, 5.3–31.1 hours; P < 0.001), as well as an accelerated reduction in delirium (23.3 hours) compared with placebo (40 hours) patients (median difference = 16 hours; 95% CI, 3–28 hours; P = 0.01). Specifically, Reade and colleagues noted dexmedetomidine was associated with a reduced time to extubation compared with placebo (HR = 0.47; 95% CI, 0.27-0.82; P = 0.007), according to a Cox hazard analysis. – by Jeff Craven

Disclosure: Young received grants and personal fees from Baxter Healthcare Corporation.