Trial reportCritical care (London, England)2024
Prevention of post-operative delirium using an overnight infusion of dexmedetomidine in patients undergoing cardiac surgery: a pragmatic, randomized, double-blind, placebo-controlled trial.
Trial report in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03477344 (Dexmedetomidine After Cardiac Surgery for Prevention of Delirium), which is not on this map. Cited by 22 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Dexmedetomidine After Cardiac Surgery for Prevention of Delirium: The Exactum Study a Randomised Double Blind Controlled Trial
Who cites it
22 citing papers in PubMed, 8 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Association Between Perioperative Sleep Disorders and Post-Operative Delirium in Cardiac Surgeries: A Systematic Review and Meta-Analysis.Journal of sleep research · 2026Pooled it
- Pooled it
- Efficacy and hemodynamic safety of perioperative dexmedetomidine for the prevention of postoperative delirium in elderly patients undergoing cardiac surgery: an updated systematic review and meta-analysis of randomized controlled trials.Frontiers in neurology · 2026Pooled it
- Dexmedetomidine for the prevention of postoperative delirium in patients undergoing cardiac surgery: a systematic review and meta-analysis with trial sequential analysis.BMC anesthesiology · 2025Pooled it
- The Effects of Dexmedetomidine on Postoperative Delirium in Adult Cardiac Surgical Patients: A Bayesian Meta-Analysis and Trial Sequential Analysis.Acta anaesthesiologica Scandinavica · 2025Pooled it
- Dexmedetomidine for delirium prevention in adult patients following cardiac surgery: a meta-analysis of randomized controlled trials.Journal of cardiothoracic surgery · 2025Pooled it
- The effect of perioperative dexmedetomidine on postoperative delirium in adult patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials.BMC anesthesiology · 2024Pooled it
- Pooled it
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Targeting neuroinflammation and PVNMaterials today. Bio · 2026Article
- Dexmedetomidine in Palestinian intensive care units: The first multicenter cross-sector survey of sedation practices, protocol gaps, and withdrawal challenges.SAGE open medicine · 2026Article
- Dexmedetomidine's Role in Adult ICU After 20 Years of Experience-A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Dexmedetomidine protects against postoperative neurocognitive disorder by mitigating mitochondrial dysfunction through regulating the IP3R-GRP75-VDAC1 complex-mediated calcium transport.Immunologic research · 2025Article
- Meta-analysis of the incidence and risk factors of postoperative delirium in organ transplant patients.World journal of psychiatry · 2025Article
- Acute compartment syndrome following cardiovascular surgery: a rare and catastrophic complication highlighting the importance of early detection and intervention.BMC cardiovascular disorders · 2025Article
- Optic nerve sheath diameter is associated with postoperative delirium in patients undergoing open heart surgery.BMC anesthesiology · 2025Observational
- Dexmedetomidine for postoperative delirium in surgical patients: a mini-review of mechanisms, clinical evidence, and practical implementation.Frontiers in pharmacology · 2025Review
- Perioperative blood pressure variability as a risk factor for postoperative delirium in the patients receiving cardiac surgery.BMC anesthesiology · 2024Article
- The Management and Prevention of Delirium in Elderly Patients Hospitalised in Intensive Care Units: A Systematic Review.Nursing reports (Pavia, Italy) · 2024Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter cardiac surgery, post-operative delirium (PoD) is acknowledged to have a significant negative impact on patient outcome. To date, there is no valuable and specific treatment for PoD. Critically ill patients often suffer from poor sleep condition. There is an association between delirium and sleep quality after cardiac surgery. This study aimed to establish whether promoting sleep using an overnight infusion of dexmedetomidine reduces the incidence of delirium after cardiac surgery.
methodsRandomized, pragmatic, multicentre, double-blind, placebo controlled trial from January 2019 to July 2021. All adult patients aged 65 years or older requiring elective cardiac surgery were randomly assigned 1:1 either to the dexmedetomidine group or the placebo group on the day of surgery. Dexmedetomidine or matched placebo infusion was started the night after surgery from 8 pm to 8 am and administered every night while the patient remained in ICU, or for a maximum of 7 days. Primary outcome was the occurrence of postoperative delirium (PoD) within the 7 days after surgery.
resultsA total of 348 patients provided informed consent, of whom 333 were randomized: 331 patients underwent surgery and were analysed (165 assigned to dexmedetomidine and 166 assigned to placebo). The incidence of PoD was not significantly different between the two groups (12.6% vs. 12.4%, p = 0.97). Patients treated with dexmedetomidine had significantly more hypotensive events (7.3% vs 0.6%; p < 0.01). At 3 months, functional outcomes (Short-form 36, Cognitive failure questionnaire, PCL-5) were comparable between the two groups.
conclusionIn patients recovering from an elective cardiac surgery, an overnight infusion of dexmedetomidine did not decrease postoperative delirium. Trial registration This trial was registered on ClinicalTrials.gov (number: NCT03477344; date: 26th March 2018).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.