Successful Delirium Prevention in Critically Ill With Dexmedetomidine
Nocturnal administration of low-dose dexmedetomidine reduces delirium in the critically ill.
HealthDay News — Low-dose dexmedetomidine significantly reduces delirium in critically ill adults, according to a study published online in the American Journal of Respiratory and Critical Care Medicine.
Yoanna Skrobik, MD, 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 (RR, 0.44; P =.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.
Skrobik Y, Duprey MS, Hill NS, Devlin JW. Low-dose nocturnal dexmedetomidine prevents ICU delirium: a randomized, placebo-controlled trial [published online March 2, 2018]. Am J Respir Crit Care Med. doi:10.1164/rccm.201710-1995OC