Intensive care unit patients on respirators who were sedated with the drug dexmedetomidine had more days alive without delirium or coma, and better sedation, compared to patients treated with the recommended drug lorazepam, according to a new study.
Benzodiazepine drugs, such as lorazepam, are routinely administered to mechanically ventilated patients to reduce pain and anxiety and to allow patients to tolerate invasive procedures in the intensive care unit (ICU).
But these medications may also increase mechanical ventilation time, ICU length of stay, and the risk of developing acute brain dysfunction, according to background information cited by the researchers. Against such a background, the researchers conducted a study to determine if dexmedetomidine, when compared with benzodiazepine drugs, reduces the duration of delirium and coma while effectively sedating mechanically ventilated ICU patients.
The randomised controlled trial included 106 adult ICU patients who were mechanically ventilated between August 2004 and April 2006. Patients were sedated with dexmedetomidine or lorazepam for as many as 120 hours.
The researchers found that dexmedetomidine patients had more days alive without delirium or coma. About 30 per cent fewer patients experienced coma in the dexmedetomidine group than in the lorazepam group. Non-significant differences were noted between the dexmedetomidine and lorazepam groups in death at 28-days and ventilator-free days.
A higher but non-significant per centage of patients in the dexmedetomidine group were able to complete post-ICU neuropsychological testing. Patients administered dexmedetomidine spent more time near the targeted level of sedation compared with patients sedated with lorazepam.
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