Newer Sedative May Reduce Delirium in ICU Patients

Dexmedetomidine might become a new standard of care, researcher says

By Steven Reinberg
HealthDay Reporter

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MONDAY, Feb. 2 (HealthDay News) -- The sedative dexmedetomidine (Precedex) reduces the time patients stay on ventilators and results in less delirium than other more commonly used drugs for patients in intensive care units, a new study finds.

For patients in ICUs, delirium is a common side effect of being sedated for an extended period; it can affect as many as 85 percent of ICU patients. Some of these patients can have lingering mental problems when they leave the hospital, problems that may last for as long as six months, experts say.

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"While dexmedetomidine provided a similar amount of time at the target level of sedation as midazolam [Versed], there were significant outcome improvements in other aspects of care," said lead researcher Dr. Richard R. Riker, director of critical care research at Maine Medical Center, in Portland.

"They came off the ventilator nearly two days faster, they had a much lower incidence of delirium, and they had a lower incidence of infection," he added.

The report was expected to be published in the Feb. 4 issue of the Journal of the American Medical Association. It is being released early to coincide with a presentation of the finding at the Society of Critical Care Medicine annual meeting, in Nashville, Tenn.

For the study, Riker's team randomly assigned 375 patients being treated in the ICU to dexmedetomidine or the more commonly used sedative midazolam. The trial ran from March 2005 to August 2007, and included patients from 68 medical centers in five countries.

Among patients receiving dexmedetomidine, 54 percent experienced delirium, compared with 76.6 percent of those receiving midazolam. In addition, patients receiving dexmedetomidine had more delirium-free days than patients receiving midazolam (2.5 days vs. 1.7 days), the researchers found.

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