| Design | International RCT, n=4,000 |
| Published | 2019 (NEJM) |
| Result | No difference in 90-day mortality between dexmedetomidine and usual sedation (29.1% vs 29.1%). Dexmedetomidine was associated with more bradycardia and hypotension. |
| Practice impact | Dexmedetomidine is not recommended as a sole primary sedative; may be used selectively as an adjunct for agitation or delirium to facilitate weaning. |
Source: The Bottom Line