Prior randomized controlled trials of dexmedetomidine & noninvasive ventilation
Devlin et al. study in June issue of CHEST
- Although literature is sparse, there is evidence supporting dexmedetomidine for patients unable to tolerate NIV, especially among patients with cardiogenic pulmonary edema. It appears to have a good safety profile when used as the sole sedative agent.
- Devlin et al. argues against the routine use of dexmedetomidine among all patients on NIV, although this study has limitations.
- Until more is known about dexmedetomidine-facilitated NIV, these patients should probably receive close ICU-level monitoring with the capability to immediately intubate if needed. Additionally, it may be sensible to reserve dexmedetomidine for situations where NIV is likely to have substantial benefit (i.e., obstructive lung disease and cardiogenic pulmonary edema).