The Analogy of Dexmedetomidine Effectiveness for the Reduction of Mechanical Ventilation Duration between Different Critical Illnesses: A Systematic Review

Critically ill patients are people who stay in intensive care units for life-threatening illnesses. Half of these patients require mechanical ventilation (MV), and use sedatives for beneficial improvement. Traditional sedatives could help, yet they may cause several potential detriments. Therefore, this review aims to compare the effectiveness of dexmedetomidine (DEX), an innovative sedation therapy, in shortening MV duration between patients with different critical illnesses. PubMed, ScienceDirect, and Cochrane were used to search for information based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement. A total of 74 articles were included. In all randomized-controlled trials, DEX showed more advantages in shortening the MV duration than reducing mortality rates. DEX therapy also improved other clinical outcomes in sepsis and septic shock patients, despite common side effects (hypotension and bradycardia). In surgical patients, more positive outcomes were witnessed in patients with cardiac surgery than other types of surgery. Despite limited evidence in patients with trauma and neurological disorders, DEX could be a safe alternative therapy. In conclusion, DEX is safe and effective for critically ill patients. Since debates still exist about DEX usage in critical care units, further investigations are needed for strengthen the evidence.