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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2018 Feb 05

DOI: 10.23736/S0375-9393.18.12350-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Light sedation with dexmedetomidine: a practical approach for the intensivist in different ICU patients

Stefano ROMAGNOLI 1 , Angela AMIGONI 2, Ilaria BLANGETTI 3, Giampaolo CASELLA 4, Cosimo CHELAZZI 1, Francesco FORFORI 5, Cristiana GARISTO 6, Maria C. MONDARDINI 7, Marco MOLTRASIO 8, Daniela PASERO 9, Tiziana PRINCIPI 10, Zaccaria RICCI 6, Fabio TARANTINO 11, Giorgio CONTI 12

1 Department of Anesthesiology and Intensive Care, Azienda Ospedaliero Universitaria Careggi, Florence, Italy; 2 Pediatric Intensive Care Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy; 3 Cardiothoracic and Vascular ICU Emergency and Critical Care Department, Santa Croce and Carle Hospital, Cuneo, Italy; 4 Intensive Care Unit, 1° Service of Anesthesia and Critical Care Emergency Department, ASST Grande Ospedale Metropolitano, Ospedale Niguarda "Cà Granda", Milan, Italy; 5 Anesthesia and Critical Care, University of Pisa, Pisa, Italy; 6 Department of Cardiology and Cardiac Surgery, Pediatric Cardiac Intensive Care Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy; 7 Paediatric Intensive Care Unit, Department of Paediatric Anaesthesia, Policlinico S. Orsola Malpighi University Hospital, Bologna, Italy; 8 Cardiac Intensive Care Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy; 9 Anesthesia and Critical Care 1, Department of Anesthesia and Critical Care, AOU Città della Salute e della Scienza di Torino, Turin, Italy; 10 Emergency Department, Clinic od Anesthesia and Critical Care, Ospedali Riuniti Ancona, Ancona, Italy; 11 Department of Anesthesia and Critical Care, Policlinico San Martino Hospital, Genoa, Italy; 12 Department of Pediatric ICU, Intensive Care and Anesthesia, Catholic University of Rome, Rome, Italy


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Light sedation, corresponding to a Richmond AgitationSedation Scale between 0 and 1 is a priority of modern critical care practice. Dexmedetomidine, a highly selective, central, 2adrenoceptor agonist, is increasingly administered in the intensive care units (ICUs) as an effective drug to induce light sedation, analgesia and a quasiphysiological sleep in critically ill patients. Although in general dexmedetomidine is well tolerated, side effects as bradycardia, hypertension, and hypotension may occur. Although a general dosing range is suggested, different ICU patients may require different and highly precise titration that may significantly vary due to neurological status, cardiorespiratory function, baseline blood pressure, heart rate, liver efficiency, age and coadministration of other sedatives. This review analyzes the use of dexmedetomidine in different settings including pediatric, adult, medical and surgical patients starting with some considerations on delirium prevention and sleep quality in critically ill patients and how dexmedetomidine may contribute to these crucial aspects. Dexmedetomidine use in specific subpopulations with unique characteristics will be detailed, with a special attention to a safe use.


KEY WORDS: Dexmedetomidine - Sedation - Analgesia - Intensive care medicine

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Publication History

Article first published online: February 05, 2018
Manuscript accepted: January 26, 2018
Manuscript revised: January 22, 2018
Manuscript received: August 6, 2017

Cite this article as

Romagnoli S, Amigoni A, Blangetti I, Casella G, Chelazzi C, Forfori F, et al. Light sedation with dexmedetomidine: a practical approach for the intensivist in different ICU patients. Minerva Anestesiol 2018 Feb 05. DOI: 10.23736/S0375-9393.18.12350-9

Corresponding author e-mail

stefano.romagnoli@unifi.it