Dexmedetomidine For The Treatment Of Acute Lung Injury: A Fact Or Fiction?

Dexmedetomidine has been widely used in the intensive care unit (ICU), with the primary aim to keep patients on an appropriate level of sedation. Both observational and randomized controlled trials have observed that the use of dexmedetomidine is associated with improved outcomes for mechanically ventilated patients [1]. In ICU patients receiving prolonged mechanical ventilation, dexmedetomidine was not inferior to other sedatives in maintaining sedation level, but was associated with shortened MV duration and improved ability to communicate pain [2]. MV is an important factor for delirium and dexmedetomidine was found to be associated with lower risk of delirium [3,4]. Prophylactic low-dose dexmedetomidine is able to reduce the occurrence of delirium during the first 7 days after surgery for patients aged over 65 years who are admitted to the ICU after surgery [4]. Thus, the beneficial effect of might be explained by the reduction of delirium in the treated group. In fact, delirium can be considered as a type of acute organ dysfunction mediated via inflammatory response. There has been evidence that inflammatory biomarkers such as C-reactive protein was positively correlated with the occurrence of delirium [5].