Dexmedetomidine Versus Propofol for Prolonged Sedation in Critically Ill 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.