Use of dexmedetomidine for sedation in mechanically ventilated adult ICU patients: a rapid practice guideline.

Adult Anesthesia Dexmedetomidine / therapeutic use Humans Hypnotics and Sedatives / therapeutic use Intensive Care Units Respiration, Artificial / methods
Clinical practice guideline Dexmedetomidine ICM-RPG Sedation

Journal

Intensive care medicine
ISSN: 1432-1238
Titre abrégé: Intensive Care Med
Pays: United States
ID NLM: 7704851

Informations de publication

Date de publication:
07 2022
Historique:
received: 18 01 2022
accepted: 24 02 2022
pubmed: 20 5 2022
medline: 14 7 2022
entrez: 19 5 2022
Statut: ppublish

Résumé

The aim of this Intensive Care Medicine Rapid Practice Guideline (ICM‑RPG) was to formulate evidence‑based guidance for the use of dexmedetomidine for sedation in invasively mechanically ventilated adults in the intensive care unit (ICU). We adhered to the methodology for trustworthy clinical practice guidelines, including use of the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of evidence, and the Evidence-to-Decision framework to generate recommendations. The guideline panel comprised 28 international panelists, including content experts, ICU clinicians, methodologists, and patient representatives. Through teleconferences and web‑based discussions, the panel provided input on the balance and magnitude of the desirable and undesirable effects, the certainty of evidence, patients' values and preferences, costs and resources, feasibility, acceptability, and research priorities. The ICM‑RPG panel issued one weak recommendation (suggestion) based on overall moderate certainty of evidence: "In invasively mechanically ventilated adult ICU patients, we suggest using dexmedetomidine over other sedative agents, if the desirable effects including a reduction in delirium are valued over the undesirable effects including an increase in hypotension and bradycardia". This ICM-RPG provides updated evidence-based guidance on the use of dexmedetomidine for sedation in mechanically ventilated adults, and outlines uncertainties and research priorities.

Identifiants

DOI: 10.1007/s00134-022-06660-x PMID: 35587274
pubmed: 35587274
doi: 10.1007/s00134-022-06660-x
pii: 10.1007/s00134-022-06660-x
doi:

Substances chimiques

Hypnotics and Sedatives 0
Dexmedetomidine 67VB76HONO

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

801-810

Informations de copyright

© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Morten H Møller (MH)

Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. mortenhylander@gmail.com.
ORCID: 0000-0002-6378-9673

Waleed Alhazzani (W)

Division of Critical Care, Department of Medicine, McMaster University, Hamilton, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Kimberley Lewis (K)

Division of Critical Care, Department of Medicine, McMaster University, Hamilton, Canada.

Emilie Belley-Cote (E)

Divisions of Cardiology and Critical Care, McMaster University, Hamilton, ON, Canada.

Anders Granholm (A)

Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

John Centofanti (J)

Department of Anesthesia, McMaster University, Hamilton, ON, Canada.

William B McIntyre (WB)

Population Health Research Institute, Hamilton, ON, Canada.
Department of Medicine, McMaster University, Hamilton, ON, Canada.

Jessica Spence (J)

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Department of Anesthesia and Critical Care, McMaster University, Hamilton, ON, Canada.

Zainab Al Duhailib (Z)

Department of Critical Care Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

Dale M Needham (DM)

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, USA.

Laura Evans (L)

Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, USA.

Annika Reintam Blaser (A)

Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia.
Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland.

Margaret A Pisani (MA)

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT, 06501, USA.

Frederick D'Aragon (F)

Department of Anesthesiology, Universite de Sherbrooke, Sherbrooke, QC, Canada.
Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.

Manu Shankar-Hari (M)

Centre for Inflammation Research, The University of Edinburgh The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK.

Mohammed Alshahrani (M)

Department of Emergency and Critical Care, College of Medicine, Imam Abdulrahman Ben Faisal University, Dammam, Saudi Arabia.

Giuseppe Citerio (G)

School of Medicine and Surgery, University Milano-Bicocca; Neurorianimazione, ASST-Monza, Monza, Italy.

Rakesh C Arora (RC)

Department of Surgery, Section of Cardiac Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.

Sangeeta Mehta (S)

Department of Medicine, Sinai Health, and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.

Timothy D Girard (TD)

Department of Critical Care Medicine, Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Otavio T Ranzani (OT)

Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain.
Pulmonary Division, Heart Institute, Hospital das Clínicas, Faculdade de Medicina, São Paulo, SP, Brazil.

Naomi Hammond (N)

Critical Care Program, The George Institute for Global Health and UNSW Sydney, Newtown, NSW, Australia.
Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia.

John W Devlin (JW)

Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA.
School of Pharmacy, Northeastern University, Boston, MA, USA.

Yahya Shehabi (Y)

Department of Intensive Care, Monash Health School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia.
School of Clinical Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.

Pratik Pandharipande (P)

Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.

Marlies Ostermann (M)

Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Use of dexmedetomidine for sedation in...
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questionsmedicales.fr › Composés hétérocycliques › Composés hétéromonocycliques › Azoles › Imidazoles › Dexmédétomidine › Use of dexmedetomidine for sedation in...
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questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Hypnotiques et sédatifs › Use of dexmedetomidine for sedation in...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Unités hospitalières › Unités de soins intensifs › Use of dexmedetomidine for sedation in...
questionsmedicales.fr › Thérapeutique › Thérapie respiratoire › Ventilation artificielle › Use of dexmedetomidine for sedation in...