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.