This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Take the CME quiz:
 Vol. 22 No. 1, July 2009
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Munkwitz, M.
PubMed
Right arrow Articles by Munkwitz, M.

AAP Grand Rounds 22:7 (2009)
© 2009 American Academy of Pediatrics

CRITICAL CARE

Dexmedetomidine vs Midazolam in Critically Ill Patients: a RCT

Source: Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA 2009;301(5):489–499; doi:10.1001/jama.2009.56[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: Among ventilated adult patients is dexmedetomidine superior to midazolam as a primary sedative agent?

Question type: Intervention

Study design: Prospective, double-blind, randomized clinical trial

 

The authors of this multinational, randomized, double-blinded trial compared the safety and efficacy of continuous dexmedetomidine to midazolam for sedation in mechanically ventilated adults. Enrolled patients were intubated and mechanically ventilated for less than 96 hours prior to start of study drug, and had an anticipated ventilation and sedation duration of at least three more days. Exclusion criteria were extensive and included pregnancy, severe brain pathology, acute liver failure, dialysis dependence, ischemic heart disease or cardiomyopathy, and those with persistent shock.

Sedation was managed using a nurse-implemented algorithm including daily drug interruption to target a light sedation goal. The Richmond Agitation-Sedation Scale1 (RASS) was used with a target score from –2 to 1. This is a score widely used in adult ICU patients. The . . . [Full Text of this Article]

Michele Munkwitz, MD
Pediatric Critical Care Medicine, University of Utah, Salt Lake City, UT