Pro: Dexmedetomidine Sedation Should Be Used Routinely for All Post-Cardiac Surgical Patients in the Intensive Care Unit.

PERIOPERATIVE CARE of cardiac surgery patients requires comprehensive multidisciplinary teamwork to ensure optimal patient outcomes. The majority of post-cardiac surgery patients are on a fast-track pathway, and timely progression through the intensive care unit (ICU) is important for optimal patient outcomes and judicious use of hospital resources. The economic impact of management decisions also is becoming an important metric for consideration. This patient population is predisposed to potentially modifiable adverse events, and therefore choice of sedation for the postoperative period should be made with care. Sedation goals should ensure patient comfort while avoiding physiologic stress and cardiac instability. Likewise, sedative agents should facilitate weaning from mechanical ventilation with rapid offset once extubation criteria are met. 1 Gupta S. Singh D. Sood D. et al. Role of dexmedetomidine in early extubation of the intensive care unit patients. J Anaesth Clin Pharm. 2015; 31: 92-98 Crossref PubMed Scopus (20) Google Scholar Sedative options have implications for duration of mechanical ventilation, development of delirium, withdrawal from other drugs/medications, ICU and hospital length of stay, as well as time to targeted sedation score. In fact, the most recent American clinical practice guidelines for ICU patients no longer use the term “sedation” and instead describe management of pain, agitation, and delirium. 2 Barr J. Fraser G. Puntillo K. et al. Clinical practice guidelines for the management of pain, agitation and delirium in adult patients in the intensive care unit. Crit Care Med. 2013; 41: 278-280 Crossref Scopus (2472) Google Scholar