Associations Between Different Sedatives and Ventilator-Associated Events, Length-of-Stay, and Mortality in Mechanically Ventilated Patients

Some years ago a multicenter clinical trial (MENDS) was conducted to evaluate optimal sedation in the critical care setting based on possible effects of the drugs used on patient’s outcomes. They concluded that dexmedetomidine was superior to benzodiacepines in several aspects like length of ICU stay or duration of mechanical ventilation amongst others (Pandharipande PP, JAMA 2007). The present manuscript reports how three different sedation agents, benzodiacepines, propofol or dexmedetomidine, might impact patient outcomes on a sample of more than 9000 episodes of mechanical ventilation in the ICU. Even though the three arms of the study (benzodiazepine, propofol and dexmedetomidine) are not equally represented, with significantly less number of patients in the dexmedetomidine group it is clear that legth of stay was longer in the benzodiacepine group. Also patients sedated with dexmedetomidne had shorter stay in the ICU than propofol. Further detailed studies should be published comparing propofol and dexmedetomidine.