During the presentation, Hughes noted that prior studies showed improvement with dexmedetomidine compared with lorazepam and midazolam with regard to delirium, coma, time receiving mechanical ventilation, and cost, though noninferiority studies found no significant impact on duration of mechanical ventilation, length of stay, or short-term mortality.
Researchers said SCCM recommends sedation with either light levels of dexmedetomidine or propofol for adults receiving mechanical ventilation and continuous sedation. The authors noted that dexmedetomidine has anti-inflammatory and bacterial properties superior to gamma-aminobutyric acid (GABA) agonists such as propofol and reduces neuronal apoptosis and promotes biomimetic sleep, which could improve clinical outcomes.
Hughes also reported lower rates of subsequent infection versus midazolam and reduced 28-day mortality in sepsis patients versus lorazepam.
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