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19-05-2022 | Hypotension | ICM Rapid Practice Guidelines

Use of dexmedetomidine for sedation in mechanically ventilated adult ICU patients: a rapid practice guideline

Authors: Morten H. Møller, Waleed Alhazzani, Kimberley Lewis, Emilie Belley-Cote, Anders Granholm, John Centofanti, William B. McIntyre, Jessica Spence, Zainab Al Duhailib, Dale M. Needham, Laura Evans, Annika Reintam Blaser, Margaret A. Pisani, Frederick D’Aragon, Manu Shankar-Hari, Mohammed Alshahrani, Giuseppe Citerio, Rakesh C. Arora, Sangeeta Mehta, Timothy D. Girard, Otavio T. Ranzani, Naomi Hammond, John W. Devlin, Yahya Shehabi, Pratik Pandharipande, Marlies Ostermann

Published in: Intensive Care Medicine | Issue 7/2022

Abstract

Purpose

The aim of this Intensive Care Medicine Rapid Practice Guideline (ICM‑RPG) was to formulate evidence‑based guidance for the use of dexmedetomidine for sedation in invasively mechanically ventilated adults in the intensive care unit (ICU).

Methods

We adhered to the methodology for trustworthy clinical practice guidelines, including use of the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of evidence, and the Evidence-to-Decision framework to generate recommendations. The guideline panel comprised 28 international panelists, including content experts, ICU clinicians, methodologists, and patient representatives. Through teleconferences and web‑based discussions, the panel provided input on the balance and magnitude of the desirable and undesirable effects, the certainty of evidence, patients’ values and preferences, costs and resources, feasibility, acceptability, and research priorities.

Results

The ICM‑RPG panel issued one weak recommendation (suggestion) based on overall moderate certainty of evidence: "In invasively mechanically ventilated adult ICU patients, we suggest using dexmedetomidine over other sedative agents, if the desirable effects including a reduction in delirium are valued over the undesirable effects including an increase in hypotension and bradycardia".

Conclusion

This ICM-RPG provides updated evidence-based guidance on the use of dexmedetomidine for sedation in mechanically ventilated adults, and outlines uncertainties and research priorities.

Available only for authorised users

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Title: Use of dexmedetomidine for sedation in mechanically ventilated adult ICU patients: a rapid practice guideline
Authors: Morten H. Møller
Waleed Alhazzani
Kimberley Lewis
Emilie Belley-Cote
Anders Granholm
John Centofanti
William B. McIntyre
Jessica Spence
Zainab Al Duhailib
Dale M. Needham
Laura Evans
Annika Reintam Blaser
Margaret A. Pisani
Frederick D’Aragon
Manu Shankar-Hari
Mohammed Alshahrani
Giuseppe Citerio
Rakesh C. Arora
Sangeeta Mehta
Timothy D. Girard
Otavio T. Ranzani
Naomi Hammond
John W. Devlin
Yahya Shehabi
Pratik Pandharipande
Marlies Ostermann
Publication date: 19-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hypotension
Hypotension
Propofol
Published in: Intensive Care Medicine / Issue 7/2022
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-022-06660-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Use of dexmedetomidine for sedation in mechanically ventilated adult ICU patients: a rapid practice guideline

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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