• Kent A Owusu, Lisa Kurczewski, Michael J Armahizer, Albert Zichichi, Carolina B Maciel, and Mojdeh S Heavner.
• Department of Pharmacy, Yale New Haven Health, 20 York Street, New Haven, CT 06510, United States of America; Clinical Redesign, Yale New Haven Health, 200 Orchard Street, New Haven, CT 06511, United States of America. Electronic address: Kent.Owusu@ynhh.org.
• J Crit Care. 2020 Dec 1; 60: 79-83.

PurposeAlthough guidelines recommend dexmedetomidine (DEX) or propofol (PRO) as preferred sedatives in critically ill adults, comparisons in neurocritical care (NCC) are limited. We aimed to evaluate the clinical utility and safety of DEX compared with PRO in NCC setting.Materials And MethodsThis retrospective, multicenter, observational cohort study conducted at three tertiary academic hospitals with Level 1 Trauma Center and Comprehensive Stroke Center designations, compared the clinical indication and safety of DEX vs PRO in patients in NCC setting.Results179 patients were included (94 DEX and 85 PRO), median age of 58, 49% were male (DEX) and 58% were male (PRO). PRO was more commonly used to manage agitation. DEX was more commonly used for facilitating extubation, alcohol withdrawal, and sedation during frequent neurologic assessments. Mean Glasgow Coma Scale scores were higher in DEX group (11 vs. 9; p = .04). The duration of either infusions, mechanical ventilation, and lengths of stay were similar. No difference was observed in hypotension or bradycardia rates. Death was significantly higher with PRO (DEX 10% vs. PRO 22%; p = .02).ConclusionsDEX and PRO were used for distinct indications in our cohort. Adverse effect profiles and clinical outcome, in the cohorts are largely similar.Copyright © 2020 Elsevier Inc. All rights reserved.

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