title: [Efficacy of dexmedetomidine for controlling delirium in intensive care unit patients].
abstract: BACKGROUND
  We have examined the effect of dexmedetomidine, a selective alpha2-adrenoreceptor agonist, for controlling delirium in patients in the intensive care unit.
  
  
  METHODS
  Intravenous infusion of dexmedetomidine (0.05-0.40 microg kg(-1) hr(-1)) was started at the onset of delirium, and its effect on sedation levels, circulation and respiration was examined in 111 patients.
  
  
  RESULTS
  Nine patients were excluded from the study because of insufficient sedation and development of bradycardia requiring additional sedatives and discontinuance of dexmedetomidine infusion, respectively. The mean Ramsay score was 1.5 before starting dexmedetomidine (baseline), which was significantly increased to 3.2 4 hours after starting dexmedetomidine infusion (n=102). Heart rate and systolic arterial blood pressure significantly decreased 6 hours after starting dexmedetomidine compared with baseline. There were no differences in respiratory rate during infusion of dexmedetomidine. In 30 patients with hypoxemia (Pa(O2)/ Fi(O2) (P/F) ratio<300), respiratory rate, tidal volume, arterial blood gas data and P/F ratio were not affected by dexmedetomidine.
  
  
  CONCLUSIONS
  Dexmedetomidine is effective for controlling delirium and provides sufficient sedation without respiratory adverse effects in patients in the intensive care unit. It is also effectively and safely used in patients with respiratory failure.
authors.affiliation: Department of Intensive Care Unit, Saiseikai Suita Hospital, Suita 564-0013.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Tamiko
authors.initials: T
authors.lastname: Okuda
authors.forename: Toru
authors.initials: T
authors.lastname: Kotani
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oda
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000188:drug therapy*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000188:drug therapy
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000316:Adrenergic alpha-Agonists; D020927:Dexmedetomidine