Dexmedetomidine has become increasingly popular in critical care and is an attractive alternative to standard sedation drugs like midazolam and propofol. Especially in the context of moderate to light sedation and when weaning the patient form mechanical ventilation. There are two European randomized double-blind studies (PRODEX, MIDEX) showing that dexmedetomidine is non inferior to propofol and midazolam in maintaining target sedation levels in mechanically ventilated intensive care unit patients. Additionally, dexmedetomidine shortened the time to extubation versus both standard sedatives, suggesting that it may reduce ICU resource needs and thus lower ICU costs.
The authors therefore decided to take a closer look at the cost factor by performing a secondary, cost-minimization analysis assessing the economics of dexmedetomidine versus standard care sedation.
Without going into details it seems that dexmedetomidine actually reduces costs in intubated patients with light to moderate sedation... and this mainly by reducing the time to extubation.
It is noteworthy that all these data and their conclusions derive from the same international research team and that the pharmaceutical company providing dexmedetomidine was involved by sponsoring.
Nevertheless, these robust results indicate:
- Dexmedetomidine is an attractive sedative for moderate to light sedation in the intubated
- Seems to shorten time to extubation
- ... and might actually be cheaper compared to 'standard' sedation
Turinen H et al. Critical Care 2015, 19:67 OPEN ACCESS
Jacob SM et al. JAMA. 2012;307(11):1151-1160. OPEN ACCESS