Print Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Bhangu A, Shah H. Bhangu A, & Shah H Bhangu, Avneesh, and Harsh Shah. Dexmedetomidine and propofol had similar outcomes in septic, mechanically ventilated adults. 2 Minute Medicine, 30 April 2021. McGraw-Hill, 2021. AccessMedicine. https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=556596§ionid=255587011APA Citation Bhangu A, Shah H. Bhangu A, & Shah H Bhangu, Avneesh, and Harsh Shah. (2021). Dexmedetomidine and propofol had similar outcomes in septic, mechanically ventilated adults. (2021). 2 minute medicine. McGraw-Hill. https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=556596§ionid=255587011.MLA Citation Bhangu A, Shah H. Bhangu A, & Shah H Bhangu, Avneesh, and Harsh Shah. "Dexmedetomidine and propofol had similar outcomes in septic, mechanically ventilated adults." 2 Minute Medicine McGraw-Hill, 2021, https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=556596§ionid=255587011. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Dexmedetomidine and propofol had similar outcomes in septic, mechanically ventilated adults by Avneesh Bhangu, Harsh Shah Listen +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. +1. Treatment with dexmedetomidine was shown not to differ from propofol treatment in adult patients with sepsis who were under mechanical ventilation. +2. No significant difference was found in functional, quality-of-life, or cognitive assessment scores between the two treatment methods. +Evidence Rating Level: 1 (Excellent) Study Rundown: + +Sedative medications are often administered in mechanically ventilated adults with sepsis for patient comfort and safety; however, they may potentiate acute brain dysfunction. Dexmedetomidine, an alpha-2 receptor agonist, has anti-inflammatory and bacterial clearance properties that are superior to GABA agonists, such as propofol, which could improve clinical outcomes. As such, this trial evaluated whether dexmedetomidine leads to better short-term and long-term outcomes compared to propofol in mechanically ventilated patients with sepsis. The study determined no significant difference in the number of calendar days alive without delirium or coma during the intervention between the two treatment groups. Furthermore, no significant difference was found in key secondary outcomes such as cognition, quality-of-life, or function assessment scores between the two treatment groups. Study limitations included variability in sedation targets set by clinicians and episodes of unmasking and crossover during the trial. Nonetheless, this study’s results are significant and strongly reinforce current guidelines which recommend the use of either dexmedetomidine or propofol for light sedation in this patient population. +Click to read the study in NEJM +Relevant Reading: Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials In-Depth [randomized controlled trial]: + +This double-blind, randomized controlled trial enrolled 432 patients. Patients included in the study were treated with continuous sedation for invasive mechanical ventilation and suspected of known infection. Patients with a baseline severe cognitive impairment, pregnant or breastfeeding, and understand approved languages were excluded from the study. The patients were randomized in a 1:1 ratio to receive either dexmedetomidine or propofol, respectively. The primary endpoint was the number of calendar days alive without delirium or coma during the 14 days of intervention. No significant difference was found in the primary outcome between the dexmedetomidine group (adjusted median, 10.7 days; 95% confidence interval [CI], 8.5 to 12.5) and the propofol group (adjusted median, 10.8 days; 95% CI, 8.7 to 12.6) (odds ratio, 0.96; 95% CI, 0.74 to 1.26, P = 0.79). Additionally, no significant difference was found in death at 90 days in the dexmedetomidine group (81 patients, 38%) and the propofol group (82 patients, 39%) (hazard ratio, 1.06; 95% CI, 0.74 to 1.52). Key secondary outcomes including cognition, function, and quality of life. No significant difference was observed between the dexmedetomidine and propofol treatment groups in the Telephone Interview for Cognition Status score after six months (adjusted median score, 40.9 vs. 41.4; odds ratio, 0.94; 95% CI. 0.66 to 1.33). Altogether, this trial shows that there is no difference in outcomes in mechanically ventilated adults with sepsis treated with dexmedetomidine compared to propofol. +©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.