Safety and efficacy of dexmedetomidine in acutely ill adults requiring non-invasive ventilation: a systematic review and meta-analysis of randomized trials.

Safety and efficacy of dexmedetomidine in acutely ill adults requiring non-invasive ventilation: a systematic review and meta-analysis of randomized trials. Chest. 2021 Jan 09;: Authors: Lewis K, Piticaru J, Chaudhuri D, Basmaji J, Fan E, Møller MH, Devlin JW, Alhazzani W Abstract BACKGROUND: While clinical studies have evaluated dexmedetomidine as a strategy to improve non-invasive ventilation (NIV) comfort and tolerance in patients with acute respiratory failure (ARF), their results have not been summarized. RESEARCH QUESTION: We sought to determine if dexmedetomidine when compared to another sedative or placebo reduces the risk of delirium, mortality, need for intubation and mechanical ventilation, or intensive care unit (ICU) length of stay (LOS) in adults with ARF initiated on NIV in the ICU? STUDY DESIGN AND METHODS: We electronically searched MEDLINE, EMBASE, and the Cochrane Library from inception to July 31st, 2020 for randomized clinical trials (RCTs). We calculated pooled relative risks (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes with the corresponding 95% confidence intervals (CIs) using a random-effect model. RESULTS: Twelve RCTs were included in our final analysis (n=738 patients). The use of dexmedetomidine, compared to other sedation strategies or placebo, reduced the risk of intubation (RR 0.54, 95% CI 0.41 to 0.71, moderate certainty), delirium (RR 0.34,...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research