Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebo-controlled trial

Lancet
Alparslan TuranDECADE Study Group

Abstract

Atrial fibrillation and delirium are common consequences of cardiac surgery. Dexmedetomidine has unique properties as sedative agent and might reduce the risk of each complication. This study coprimarily aimed to establish whether dexmedetomidine reduces the incidence of new-onset atrial fibrillation and the incidence of delirium. A randomised, placebo-controlled trial was done at six academic hospitals in the USA. Patients who had had cardiac surgery with cardiopulmonary bypass were enrolled. Patients were randomly assigned 1:1, stratified by site, to dexmedetomidine or normal saline placebo. Randomisation was computer generated with random permuted block size 2 and 4, and allocation was concealed by a web-based system. Patients, caregivers, and evaluators were all masked to treatment. The study drug was prepared by the pharmacy or an otherwise uninvolved research associate so that investigators and clinicians were fully masked to allocation. Participants were given either dexmedetomidine infusion or saline placebo started before the surgical incision at a rate of 0·1 μg/kg per h then increased to 0·2 μg/kg per h at the end of bypass, and postoperatively increased to 0·4 μg/kg per h, which was maintained until 24 h. The coprim...Continue Reading

Associated Clinical Trials

Dec 9, 2013·Alparslan Turan, Alparslan Turan

Citations

Dec 15, 2020·Current Opinion in Anaesthesiology·Thomas DuningDaniel Oswald
Jan 4, 2021·European Heart Journal·Harry J G M CrijnsJosep Brugada
Jan 23, 2021·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak
Mar 12, 2021·Journal of Clinical Anesthesia·Hassan HamadnallaAlparslan Turan
Apr 10, 2021·International Journal of Geriatric Psychiatry·Zhijun Lu
Apr 30, 2021·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·SiBo LiuJinJie Liu
May 15, 2021·Seminars in Cardiothoracic and Vascular Anesthesia·Samuel GillilandNathaen Weitzel
Jun 5, 2021·British Journal of Anaesthesia·Ke PengFu-Hai Ji
Jul 13, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Suzana M ZorcaAlexander D Shapeton
Aug 22, 2021·The Journal of Thoracic and Cardiovascular Surgery·Kiichi EnomotoHomare Okamura
Aug 28, 2021·Cancers·Gennaro Carmine SemeraroDaniela Maria Cardinale
Aug 30, 2021·The Journal of Thoracic and Cardiovascular Surgery·Edward BurattoIgor E Konstantinov
Sep 11, 2021·British Journal of Anaesthesia·Jessica K Goeller, Karsten Bartels
Sep 22, 2021·Current Opinion in Critical Care·Allan MigirovKamal Maheshwari

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