ICU sedation, delirium & recovery
Effects of dexmedetomidine versus propofol on outcomes in critically ill patients with different sedation depths: a propensity score-weighted cohort study
Authors' conclusion
Our results indicated that, compared with propofol, DEX had beneficial and adverse impacts on certain ICU outcomes in critically ill patients, and these impacts appeared to depend on sedation depths.
Study context
- Population
- Adult Intensive Care Unit (ICU) patients, Medical Information Mart for Intensive Care IV database, 2008 to 2019
- Participants
- 107 vs 2,318
- Exposure
- Dexmedetomidine (DEX) vs propofol as primary sedative
- DEXn = 107
- Propofoln = 2,318reference
- Outcome
- ICU outcomes
Methodological detailsstabilized inverse probability of treatment weighting, MIMIC-IV database
- Stabilized inverse probability of treatment weighting
- MIMIC-IV database
Main finding
As reported in the abstract
- DEX: longer ventilator-free days on day 28 vs propofol
- DEX: shorter ICU stay vs propofol
- Null associations of DEX with 90-day ICU mortality, persistent organ dysfunction on day 14, AKI, and vasopressor-free days on day 28
Observational data: associations, not effects.
Further findings
Outcomes by sedation depth (subgroup)
- Richmond Agitation Sedation Scale (RASS) ≥−2: DEX positively impacted persistent organ dysfunction on day 14, ventilator-free days on day 28, and ICU stay
- RASS <−2: DEX negatively impacted 90-day ICU mortality, persistent organ dysfunction on day 14, and ventilator-free days on day 28
Original publication
Effects of dexmedetomidine versus propofol on outcomes in critically ill patients with different sedation depths: a propensity score-weighted cohort study. Anaesth Crit Care Pain Med. Published 16 September 2024. doi:10.
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