Dexmedetomidine Versus Propofol for Prolonged Sedation in Critically Ill Trauma and Surgical Patients

Dexmedetomidine Versus Propofol for Prolonged Sedation in Critically Ill Trauma and Surgical Patients

The purpose of this study is to assess the efficacy of dexmedetomidine versus propofol for prolonged sedation in trauma and surgical patients.

Design: Open-label, single-center prospective study. Setting: Trauma/Surgical Intensive Care Unit (TSICU) at a Level I academic trauma center.

Patients: Patients 18 years of age or older requiring mechanical ventilation and admitted to the TSICU Interventions: Patients were randomly assigned based on unit bed location to receive dexmedetomidine or propofol for sedation.

Inclusion Criteria:

• Patients were included in the study if they were 18 years of age or older,
• mechanically ventilated,
• placed on the institutional sedation protocol,
• expected to require sedation lasting 24 hours after randomization, and
• admitted to the TSICU and followed by the Trauma/Surgical Service.

Exclusion Criteria:

Patients were excluded for any of the following:

• 72 hours or greater since sedation protocol initiation,
• treatment per the institutional traumatic brain injury (TBI) protocol,
• concomitant continuous infusion of a neuromuscular blocking agent,
• heart rate less than 50 beats per minute,
• mean arterial pressure less than 55 mmHg despite fluid resuscitation and vasopressors, and
• use of other alpha-2 agonists within 24 hours of randomization.