ArticleCritical care science2025
A target trial emulation of dexmedetomidine to treat agitation in the intensive care unit.
Article in Critical care science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Dexmedetomidine's Role in Adult ICU After 20 Years of Experience-A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Review
- The dawn of target trials in intensive care: time to move beyond association is not causation.Intensive care medicine · 2025Article
- The Challenges of Diagnosing, Managing, and Preventing Pediatric Delirium.Children (Basel, Switzerland) · 2025Review
- Expanding the critical care collaboration between Australia, New Zealand, and Brazil: The role of journals.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Article
- Bringing credibility to observational research in critical care: the case of target trial emulation designs.Critical care science · 2025Article
- Target trial emulation on dexmedetomidine for critically ill patients: all that glitters is not gold.Critical care science · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAgitation is a major problem in the intensive care unit. However, no treatment has clearly emerged as effective and safe. Using target trial emulation, we aimed to test the hypothesis that early intervention with dexmedetomidine would accelerate agitation resolution.
methodsWe read clinical notes in an electronic medical records system with natural language processing to identify patients with agitation. We obtained their demographics, trajectories, associations, and outcomes. We used g-formulas to study the possible effects of dexmedetomidine on agitation resolution and key outcomes.
resultsWe screened 7525 patients. Overall, 2242 patients (29.8%) developed within-intensive care unit agitation, and 2052 (27.3%) were eligible for inclusion in the target trial emulation, with 314 treated with dexmedetomidine. Dexmedetomidine-treated patients had more severe illness and were more likely to have unplanned emergency admissions with medical diagnoses. However, they achieved higher rates of resolution of within-intensive care unit agitation (94% versus 72%; p < 0.001) and lower 30-day mortality (5% versus 9%; p = 0.033). Early initiation of dexmedetomidine accelerated the resolution of agitation (risk ratio [RR] 1.13 [95%CI 1.03 - 1.21]; risk difference [RD] 9.8% [95%CI 2.6% - 15.4%]); extubation by Day 30 (RR 1.03 [95%CI 1.02 - 1.04]; RD 3.1% [95%CI 2.2% - 4.2%]); and reduced the chance of having a tracheostomy by Day 30 (RR 0.67 [95%CI 0.34 - 0.99]; RD -3.5% [95%CI -7.0% - -0.0%]).
conclusionThrough target trial emulation analysis, early dexmedetomidine was associated with an increased rate of resolution of agitation and extubation and decreased tracheostomy risk.
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