ArticleBMC anesthesiology2026
Early goal-directed sedation with dexmedetomidine is associated with lower delirium rate in mechanically ventilated patients.
Article in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Effect of a goal-directed sedation nursing intervention bundle on comfort and compliance in children undergoing bronchoalveolar lavage under topical anesthesia with procedural sedation: a randomized controlled trial.Frontiers in medicine · 2026Article
- Exploring the Cognitive Phenotypes of Implementation Barriers to Analgesia and Sedation Management Among ICU Nurses: A Q Methodology Study.Journal of nursing management · 2026Article
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6 authors.
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Abstract
backgroundDelirium remains a critical complication in mechanically ventilated ICU patients, with deep sedation strategies implicated in its pathogenesis. This study evaluates whether an early goal-directed sedation (EGDS) strategy is associated with delirium rate and clinical outcomes in mechanically ventilated patients.
methodsIn this single-center retrospective cohort study, 412 mechanically ventilated adults from a tertiary ICU (2022–2024) were categorized into EGDS (n = 208) and conventional sedation (n = 204) groups. The EGDS protocol included dexmedetomidine titration (RASS − 2 to 0), nurse-driven, protocolized targeted sedation and multimodal analgesia (BPS ≤ 3). Primary outcome was delirium rate (CAM-ICU); secondary outcomes encompassed mechanical ventilation duration, ICU stay, and safety events.
resultsDelirium rate was significantly lower in the EGDS group (32.2% vs. 48.0%, P < 0.001). EGDS patients demonstrated shorter median mechanical ventilation duration (4 vs. 5 days, P = 0.003) and ICU stay (6 vs. 8 days, P = 0.001). Adverse events including hypotension (12.0% vs. 18.6%, P = 0.048) and respiratory suppression (5.3% vs. 10.3%, P = 0.032) were fewer with EGDS. Cox regression showed EGDS was associated with a 44% lower hazard of delirium (aHR = 0.56, 95% CI 0.39–0.81).
conclusionIn this retrospective cohort, patients who achieved EGDS goals had a lower observed delirium rate and shorter ICU stay; these findings are associative and do not establish causality. These real-world findings suggest associations between EGDS and improved outcomes, supporting further evaluation of protocolized sedation strategies.
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