This is for our readers who treat ICU patients
Patients receiving low-dose dexmedetomidine report no changes in sleep quality
Low-dose dexmedetomidine significantly reduces delirium in critically ill adults, according to a study published online March 2 in the American Journal of Respiratory and Critical Care Medicine.
Yoanna Skrobik, M.D., from McGill University in Montreal, and colleagues randomized 100 delirium-free, critically ill adults receiving sedatives to receive nocturnal intravenous dexmedetomidine (0.2 mcg/kg/min) or placebo until discharge from the intensive care unit (ICU). Effect on delirium and sleep was assessed.
The researchers found that nocturnal dexmedetomidine was associated with a greater proportion of patients who remained delirium-free during the ICU stay (relative risk, 0.44; P = 0.006). However, the average Leeds Sleep Evaluation Questionnaire score was similar between the two groups. The groups also had similar incidence of hypotension, bradycardia, or both.
“To our knowledge, this study, that suggests that the nocturnal administration of low-dose dexmedetomidine significantly reduces delirium without increasing adverse events, is the first to describe an effective pharmacologic delirium prevention intervention in critically ill adults,” the authors write.