BACKGROUND: @entity6948 is an a(2)-receptor agonist used for sedation in the intensive care unit (ICU). Although @entity6948 is labeled for sedation in critically ill @entity1 at doses up to 0.7  g/kg/h, recent studies have used more liberal dosing regimens. However, to our knowledge, no study has assessed the clinical impact of doses greater than 0.7  g/kg/h when compared to doses within the Food and Drug Administration--approved labeling. OBJECTIVE: To compare the clinical efficacy and safety of high ( @entity2033 ) and low (LD) doses of @entity6948 for sedation in the ICU. METHODS: This retrospective study included a sample of @entity1 who received @entity6948 in medical, surgical, medical/surgical, and cardiothoracic ICUs between January 1, 2008, and December 1, 2009. @entity1 were included in the LD group if their maximum dose was less than 0.7  g/kg/h or in the @entity2033 group if any dose was more than 0.7  g/kg/h. Efficacy was determined by the percentage of Richmond Agitation and Sedation Scale (RASS) scores for each @entity1 maintained at goal sedation (-1 to +1), and safety was determined by the incidence of @entity551 and @entity1168 . RESULTS: Forty-three of 133 @entity1 received @entity2033 @entity6948 . @entity1 in the LD group had a significantly higher percentage of RASS scores at goal (60.0% vs 48.6%; p = 0.03), while those in the @entity2033 group experienced a higher percentage of RASS scores classified as undersedated (19.2% vs 4.9%; p = 0.001). There was no significant difference in the incidence of @entity551 or @entity1168 between groups. CONCLUSIONS: @entity1 treated with @entity2033 @entity6948 had fewer RASS scores at goal. Our data suggest that increasing the dose of @entity6948 may not enhance sedation efficacy or lead to an increased incidence of adverse effects. @entity1 who have not achieved goal sedation at doses of 0.7  g/kg/h or less may not respond further to increased doses.

High-dose XXXX for sedation in the intensive care unit: an evaluation of clinical efficacy and safety.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity2033 :: ('MESH:D006816', 'Disease') :: ['HD'] @entity6948 :: ('MESH:D020927', 'Chemical') :: ['dexmedetomidine', 'Dexmedetomidine'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity1168 :: ('MESH:D001919', 'Disease') :: ['bradycardia']
@entity6948 :: (MESH:D020927,Chemical) :: ['dexmedetomidine']
