TY  - JOUR
T1  - MEdications for sedation in patients with prolonged mechanical ventilation
AU  - Xue FS, Liao X, Yuan YJ
Y1  - 2012/06/27
N1  - 10.1001/jama.2012.5972
JO  - JAMA
SP  - 2587
EP  - 2589
VL  - 307
IS  - 24
N2  - 
To the Editor: In the 2 randomized controlled trials by Dr Jakob and colleagues,1 the authors concluded that among intensive care unit (ICU) patients receiving prolonged mechanical ventilation, dexmedetomidine was noninferior to midazolam and propofol in maintaining light to moderate sedation. In their trials, the target sedation Richmond Agitation-Sedation Scale (RASS) scores ranged from 0 to −3. However, we noticed that during sedation maintenance, patients receiving dexmedetomidine had higher actual RASS scores than those receiving midazolam or propofol. That is, those receiving midazolam or propofol compared with dexmedetomidine were at a deeper sedation level. In the absence of a comparable sedation level of medications between groups, the secondary outcome findings, such as nurses' assessment of arousal, patients' ability to cooperate with care, and patients' ability to communicate pain, should be interpreted with caution.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.5972
UR  - http://dx.doi.org/10.1001/jama.2012.5972
ER  -