title: Role of dexmedetomidine for the prevention and treatment of delirium in intensive care unit patients.
abstract: OBJECTIVE
  To review recent clinical studies regarding the role of dexmedetomidine for prevention and treatment of delirium in intensive care unit (ICU) patients.
  
  
  METHODS
  MEDLINE and PubMed searches (1988-Feburary 2013) were conducted, using the key words delirium, dexmedetomidine, Precedex, agitation, α-2 agonists, critical care, and intensive care. References from relevant articles were reviewed for additional information.
  
  
  METHODS
  Clinical trials comparing dexmedetomidine with other sedatives/analgesics or with antipsychotics for delirium were selected. Studies that evaluated the use of dexmedetomidine for sedation for more than 6 hours were included in this review.
  
  
  RESULTS
  Dexmedetomidine is a highly selective α-2 receptor agonist that provides sedation, anxiolysis, and modest analgesia with minimal respiratory depression. Its mechanism of action is unique compared with that of traditional sedatives because it does not act on γ-aminobutyric acid receptors. In addition, dexmedetomidine lacks anticholinergic activity and promotes a natural sleep pattern. These pharmacologic characteristics may explain the possible anti delirium effects of dexmedetomidine. Eight clinical trials, including 5 double-blind randomized trials, were reviewed to evaluate the impact of dexmedetomidine on ICU delirium.
  
  
  CONCLUSIONS
  Currently available evidence suggests that dexmedetomidine is a promising agent, not only for prevention but also for treatment of ICU-associated delirium. However, larger, well-designed trials are warranted to define the role of dexmedetomidine in preventing and treating delirium in the ICU.
authors.affiliation: Critical Care, College of Pharmacy, Western New England University, Springfield, MA, USA. yoonsun.mo@wne.edu
authors.forename: Yoonsun
authors.initials: Y
authors.lastname: Mo
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Zimmermann
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods*; D003693:Delirium / Q000188:drug therapy* / Q000517:prevention & control* / Q000523:psychology; D020927:Dexmedetomidine / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine