Feasibility of dexmedetomidine in facilitating extubation in the intensive care unit

Journal of Clinical Pharmacy and Therapeutics
P A ArpinoB T Thompson

Abstract

Spontaneous breathing trials (SBT) and intermittent mandatory ventilation (IMV) are common techniques utilized to expedite the ventilator weaning process. These techniques often require the reduction and/or discontinuation of sedatives and analgesics. Reducing these medications can lead to agitation and the inability to conduct SBTs or weaning by IMV. Adding dexmedetomidine (dex), a potent alpha-2-adrenergic receptor agonist that possesses sedative, anxiolytic and analgesic effects without causing significant respiratory depression, may facilitate extubation in these patients. To assess the feasibility of adding dex to facilitate extubation in a group of difficult-to-extubate patients secondary to agitation. Mechanically ventilated patients who were deemed difficult to wean and extubate secondary to agitation were evaluated for dex therapy. Inclusion criteria were location in an intensive care unit, intubated and mechanically ventilated, required IV sedation, deemed suitable by unit criteria for weaning and extubation within 24 h of dex initiation, previous attempts at weaning sedation and/or analgesia resulted in agitation causing either severe patient ventilator dyssynchrony, prolong need for intubation, or an inability to co...Continue Reading

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