Fewer Ventilator Days with Dexmedetomidine Use for Patients Difficult to Extubate Implementation Study

Background Traditional sedation for mechanically ventilated patients causes delirium which increases the patients’ length of stay while hospitalized. When extubation is attempted, these medications must be discontinued due to the side effect of respiratory depression, leaving patients anxious and agitated, delaying extubation and prolonging the need for mechanical ventilation. Dexmedetomidine is an alternative sedative that does not cause delirium or respiratory depression. During the weaning process, dexmedetomidine can be continued, allowing the patient to remain calm and successfully extubated.

Objectives To decrease the length of stay for mechanically ventilated patients by implementing a dexmedetomidine protocol for difficult to extubate patients during the weaning process.

Methods A pre/post design study was done comparing the patient mean of length of stay on mechanical ventilation. A Mann-Whitney U-Test was used due to the small sample size.

Results Over the three-month implementation period, 15 patients received dexmedetomidine. None of the patients experienced adverse reactions while on dexmedetomidine. There was a trend of decreasing mechanical ventilation length of stay but no significant difference was noted between the pre-implementation group and the post.

Conclusion Dexmedetomidine was a safe alternative to traditional sedation for difficult to extubate patients when a bolus dose was not given.