Newer Sedative Might Help Patients on Ventilators

Preliminary study finds dexmedetomidine caused less delirium

By Serena Gordon
HealthDay Reporter

Related Healthscout Videos Hospitals Going High-Tech Video Interview: Dr. Atul Gawande on the Role of Patients in Improving Medical Care Closing Holes In Kids' Hearts Beat The Bean Counters More... Related News Articles • Specialized Stroke Care Improves Outcomes • Patient's Race Doesn't Affect Emergency Room Care • China Documents First Case of Tick-Borne Disease Spread • Toxic Chemicals Blamed for Gulf War Illness More...

TUESDAY, Dec. 11 (HealthDay News) -- Doctors routinely use sedatives on patients who are hooked up to mechanical ventilators in intensive care units, but some experts worry that too much sedation might slow down recovery and leave patients in an unnecessary fog.

Now, researchers report that by substituting a newer medication, dexmedetomidine (Precedex), for the more commonly used lorazepam (Ativan), doctors could reduce the amount of time patients experience delirium and coma. They also found a reduction in the length of time on mechanical ventilation and an improvement in survival, though these differences didn't reach the level of statistical significance.

Text Continues Below

---

"By changing the way we give medications, we may be able to improve outcomes," said study author Dr. Pratik Pandharipande, from the anesthesiology and critical care department at Vanderbilt University Medical Center in Nashville, Tenn. His report is published in the Dec. 12 issue of the Journal of the American Medical Association.

"By incorporating this sedative, patients had four more days alive without delirium or coma. They also had greater time off the mechanical ventilator and had shorter ICU stays. And, there was an important trend toward decreased mortality, about a 10 percent reduction in mortality," he said.

However, not everyone is convinced that the newer sedative is a significant improvement.

"This study reminds me of the importance in minimizing sedation. The principles of this study make sense to me, but the study is flawed. They started using 10 milligrams per hour of lorazepam, and it's a dose we don't use. It's a rarity to use a dose that high," said Dr. Kevin Grady, interim chief medical officer for St. John's Health System and director of pulmonary and critical care at St. John Hospital and Medical Center in Detroit. Grady said a more standard dose of lorazepam is 2 to 4 milligrams per hour.

Page:  1 | 2 | Next >>