6/29/23, 11:41 PM SEDCOM Pathway Feedback Search Clinical Topics Home Studies SEDCOM SEDCOM Trial question What is the effect of dexmedetomidine for sedation in mechanically ventilated ICU patients? Study design Multi-center Double blinded RCT Population Characteristics of study participants 50.0% female N = 375 50.0% male 375 patients (184 female, 182 male) Inclusion criteria: adult patients intubated and mechanically ventilated for < 96 hours with expected mechanical ventilation for > 24 hours Key exclusion criteria: trauma or burns as admitting diagnoses, dialysis, pregnancy or lactation, neuromuscular blockade other than for intubation, epidural or spinal analgesia, serious CNS pathology, acute hepatitis or severe liver disease, unstable angina or acute myocardial infarction Interventions N=244 dexmedetomidine (0.2-1.4 g/kg/hour titrated to achieve light sedation) N=122 midazolam (0.02-0.1 mg/kg/hour titrated to achieve light sedation) Primary outcome Time within target Richmond Agitation and Sedation Scale range 77.3 % 77.3 75.1 58.0 % 38.6 % 19.3 % https://web.pathway.md/studies/recaIeEuSIAgfqnu5 1/2 6/29/23, 11:42 PM SEDCOM Pathway No significant difference 0.0 % Dexmedetomidine Midazolam No significant difference in time within the target Richmond Agitation and Sedation Scale range (77.3% vs. 75.1%; AD 2.2%, 95% CI -3.2 to 7.5) Secondary outcomes Significant decrease in prevalence of delirium during treatment (54% vs. 76.6%; ARD -22.6, 95% CI -36.01 to -9.19) Significant decrease in time to extubation (3.7 days vs. 5.6 days; AD -1.9 days, 95% CI -3.35 to -0.45) No significant difference in length of ICU stay (5.9 days vs. 7.6 days; AD -1.7 days, 95% CI -4.52 to 1.12) Safety outcomes No significant differences in death from all causes at 30 days, drug discontinuation due to adverse events. Significant differences in bradycardia (42.2% vs. 18.9%), tachycardia (25.4% vs. 44.3%), and hypertension requiring treatment (18.9% vs. 29.5%). Conclusion In adult patients intubated and mechanically ventilated for < 96 hours with expected mechanical ventilation for > 24 hours, dexmedetomidine was not superior to midazolam with respect to time within the target Richmond Agitation and Sedation Scale range. Reference Riker RR, Shehabi Y, Bokesch PM et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA. 2009 Feb 4;301(5):489-99. Open reference URL https://web.pathway.md/studies/recaIeEuSIAgfqnu5 2/2