The purpose of this randomized, double-blind study is to evaluate the utility of transitioning benzodiazepine sedation to dexmedetomidine in medical or surgical ICU patients requiring sedation when tracheal extubation is nearing.
50 medical or surgical ICU patients requiring sedation with benzodiazepine therapy and qualifying for daily awakenings will be randomized in a double-blind manner to receive additional midazolam or dexmedetomidine. This study is unique because midazolam or dexmedetomidine will be added, in a blinded fashion, to existing sedation and analgesia in an effort to decrease or possibly discontinue these therapies. The practice of daily discontinuation of sedation and analgesia will be applied to all existing and experimental regimens.
The specific objectives of this study are to determine if transitioning conventional sedation to dexmedetomidine facilitates tracheal extubation, shortens ventilator time, reduces doses of conventional sedatives and analgesics, maintains patient comfort and safety, and alters the total cost of sedation.
Consent will be provided by the next of kin or legally authorized representative within 24 hours of the subject qualifying for daily awakenings.
The study is supported by an investigator-initiated grant from Hospira.