A study presented at this year's American Society of Anesthesiologists (ASA) Annual Meeting demonstrated that the use of the sedative Dexmedetomidine was safe and reduced the amount of time for the extubation process, or the process of removing a tube from the airway of critically ill patients. The study participants had failed previous attempts to remove respiratory machine ventilation support.
"Currently, if a patient cannot be successfully extubated, no viable alternative exists aside from performing additional weaning attempts and, in some cases, a tracheotomy," said lead study author Julin F. Tang, M.D., M.S., FCCM, Clinical Professor, Department of Anesthesia and Perioperative Care at San Francisco General Hospital. "This is tremendously hard on the patient. Now, based on the results of this study, Dexmedetomidine may be a viable option for patients who have failed previous attempts to remove the respiratory tubes because it appears to inhibit a stress response in the body that can make it difficult to extubate."
The prospective, randomized controlled study was conducted among 20 critically ill, intensive care patients that were equally randomized to either the control group or the Dexmedetomidine treatment group (10:10). Patients in the control group were weaned from ventilation according to standard hospital protocol. Those in the Dexmedetomidine group received the drug at 0.5 or 0.7mcg/kg/hr. Background sedation and analgesia were gradually decreased in the treatment group and aerosolized lidocaine was initiated prior to weaning. Shortly after Dexmedetomidine infusion, pressure support ventilation (PSV) was initiated and patients were weaned and extubated.