Safety and efficacy of dexmedetomidine for long-term sedation in critically ill patients

Journal of Anesthesia

Volumn 28, Issue 1, 2014, Pages 38-50

  Ozaki, Makoto ^a   Takeda, Junzo ^b   Tanaka, Keiji ^c   Shiokawa, Yasuhiro ^d   Nishi, Shinichi ^e   Matsuda, Kenichi ^f   Doi, Matsuyuki ^g   Kakihana, Yasuyuki ^h   Fujino, Yuji ⁱ   Takinami, Masanori ^j   Kawai, Misa ^k  

^a TOKYO WOMEN S MEDICAL UNIVERSITY MEDICAL CENTER EAST   (Japan)

^b KEIO UNIVERSITY   (Japan)

^c NIPPON MEDICAL SCHOOL HOSPITAL   (Japan)

^d KINDAI UNIVERSITY HOSPITAL   (Japan)

^e HYOGO COLLEGE OF MEDICINE   (Japan)

^f UNIVERSITY OF YAMANASHI   (Japan)

^g HAMAMATSU UNIVERSITY SCHOOL OF MEDICINE   (Japan)

^h KAGOSHIMA UNIVERSITY HOSPITAL   (Japan)

ⁱ OSAKA UNIVERSITY HOSPITAL   (Japan)

^j JIKEI UNIVERSITY SCHOOL OF MEDICINE   (Japan)

^k Osaka Office   (Japan)

more..

Author keywords

Dexmedetomidine; Intensive care unit; Long term; Sedation; Withdrawal

Indexed keywords

ANALGESIC AGENT; DEXMEDETOMIDINE; HYPNOTIC SEDATIVE AGENT;

AGED; CLINICAL TRIAL; CRITICAL ILLNESS; DRUG EFFECTS; FEMALE; HEART RATE; HUMAN; HYPOTENSION; INTENSIVE CARE UNIT; MALE; MIDDLE AGED; MULTICENTER STUDY; PHASE 3 CLINICAL TRIAL; PROSPECTIVE STUDY; TIME; VERY ELDERLY;

AGED; AGED, 80 AND OVER; ANALGESICS; CRITICAL ILLNESS; DEXMEDETOMIDINE; FEMALE; HEART RATE; HUMANS; HYPNOTICS AND SEDATIVES; HYPOTENSION; INTENSIVE CARE UNITS; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; TIME FACTORS;

EID: 84894493979     PISSN: 09138668     EISSN: 14388359     Source Type: Journal    
DOI: 10.1007/s00540-013-1678-5     Document Type: Article

References (28)

1. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, Davidson JE, Devlin JW, Kress JP, Joffe AM, Coursin DB, Herr DL, Tung A, Robinson BR, Fontaine DK, Ramsay MA, Riker RR, Sessler CN, Pun B, Skrobik Y, Jaeschke R. American College of Critical Care Medicine. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41:263-306.
2. Rello J, Diaz E, Roque M, Vallés J. Risk factors for developing pneumonia within 48 hours of intubation. Am J Respir Crit Care Med. 1999;159:1742-6.
3. Jones C, Griffiths RD, Humphris G, Skirrow PM. Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med. 2001;29:573-80.
4. Devlin JW. The pharmacology of oversedation in mechanically ventilated adults. Curr Opin Crit Care. 2008;14:403-7.
5. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96:1004-17.
6. Arnold HM, Hollands JM, Skrupky LP, Mice ST. Optimizing sustained use of sedation in mechanically ventilated patients: focus on safety. Curr Drug Saf. 2010;5:6-12.
7. Blanchard AR. Sedation and analgesia in intensive care. Medications attenuate stress response in critical illness. Postgrad Med 2002;111:59-60, 63-64, 67-70.
8. Kamibayashi T, Maze M. Clinical uses of α2-adrenergic agonists. Anesthesiology. 2000;93:1345-9.
9. Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000;90:699-705.
10. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382-94.
11. Hsu YW, Cortinez LI, Robertson KM, Keifer JC, Sum-Ping ST, Moretti EW, Young CC, Wright DR, Macleod DB, Somma J. Dexmedetomidine pharmacodynamics. Part I: Crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101:1066-76.
12. Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA. 2012;307:1151-60.
13. Riker RR, Shehabi Y, Bokesch PM, Ceraso D, Wisemandle W, Koura F, Whitten P, Margolis BD, Byrne DW, Ely EW, Rocha MG. Dexmedetomidine vs. midazolam for sedation of critically ill patients: a randomized trial. JAMA. 2009;301:489-99.
14. Shehabi Y, Ruettimann U, Adamson H, Innes R, Ickeringill M. Dexmedetomidine infusion for more than 24 hours in critically ill patients: sedative and cardiovascular effects. Intensive Care Med. 2004;30:2188-96.
15. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, Tesoro EP, Elswick RK. The Richmond Agitation-Sedation Scale. Validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338-44.
16. Sumi M, Tango T. Inference on the rate ratio of recurrent events for the matched pairs design. Stat Med. 2010;29:3186-93.
17. Diprivan [Package Insert]. AstraZeneca Pharmaceuticals. 2004.
18. Midazolam hydrochloride [Package Insert]. Lake Forest, IL: Hospira, Inc. 2005.
19. Akada S, Takeda S, Yoshida Y, Nakazato K, Mori M, Hongo T, Tanaka K, Sakamoto A. The efficacy of dexmedetomidine in patients with noninvasive ventilation: a preliminary study. Anesth Analg. 2008;107:167-70.
20. Takasaki Y, Kido T, Semba K. Dexmedetomidine facilitates induction of noninvasive positive pressure ventilation for acute respiratory failure in patients with severe asthma. J Anesth. 2009;23:147-50.
21. Scala R. Hypercapnic encephalopathy syndrome: a new frontier for non-invasive ventilation? Respir Med. 2011;105:1109-17.
22. Maldonado JR, Wysong A, van der Starre PJ, Block T, Miller C, Reitz BA. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics. 2009;50:206-17.
23. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, Speroff T, Gautam S, Bernard GR, Inouye SK. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29:1370-9.
24. Shafer A. Complications of sedation with midazolam in the intensive care unit and a comparison with other sedative regimens. Crit Care Med. 1998;26:947-56.
25. Carrasco G, Molina R, Costa J, Soler JM, Cabré L. Propofol versus midazolam in short-, medium-, and long-term sedation of critically ill patients. Chest. 1993;103:557-64.
26. Shelly MP, Mendel L, Park GR. Failure of critically ill patients to metabolize midazolam. Anesthesia. 1987;42:619-26.
27. Zapantis A, Leung S. Tolerance and withdrawal issues with sedation. Crit Care Nurs Clin N Am. 2005;17:211-23.
28. Riker RR, Fraser GL. Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit. Pharmacotherapy. 2005;25:8S-18S.