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Newer Sedative Might Help Patients on Ventilators
Date:12/11/2007

f lorazepam is 2 to 4 milligrams per hour.

"This just doesn't prove to me that dexmedetomidine is better than lorazepam," added Grady.

The current study included 106 people hospitalized in the ICU and on mechanical ventilators. They were randomly assigned to receive sedation either with dexmedetomidine or with lorazepam. The sedation period varied but lasted as long as 120 hours.

While the manufacturer of dexmedetomidine, Hospira, provided an unrestricted grant and the study medication to the researchers, the company had no input in the study's design, conduct or analysis, according to the authors.

The researchers found that sedation with dexmedetomidine reduced the number of days that patients experienced delirium or coma by an average of four days. The prevalence of coma was 92 percent for those on lorazepam and 63 percent for those on dexmedetomidine.

The 28-day mortality rate was 27 percent for the lorazepam group versus 17 percent for those on dexmedetomidine.

According to Pandharipande, although the initial cost of dexmedetomidine might be higher than that of lorazepam, the improved outcomes offset that cost.

Because the study size was small, Pandharipande said more research needs to be done to confirm these findings, but that this study offered "proof of concept."

"We do have an alternate sedation strategy to reduce the burden of brain dysfunction," said Pandharipande.

Grady said there are certain patients who may benefit more from the use of dexmedetomidine, such as those going through alcohol withdrawal. But, until further studies are done, Grady added, "I'm hard-pressed to think it's worth the expense. This drug costs twice as much as lorazepam."

More information

Read more about lorazepam and its potential side effects at the U.S. National Library o
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