• Morten H Møller, Waleed Alhazzani, Kimberley Lewis, Emilie Belley-Cote, Anders Granholm, John Centofanti, William B McIntyre, Jessica Spence, Zainab Al Duhailib, Dale M Needham, Laura Evans, Reintam BlaserAnnikaADepartment of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia.Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland., Margaret A Pisani, Frederick D'Aragon, Manu Shankar-Hari, Mohammed Alshahrani, Giuseppe Citerio, Rakesh C Arora, Sangeeta Mehta, Timothy D Girard, Otavio T Ranzani, Naomi Hammond, John W Devlin, Yahya Shehabi, Pratik Pandharipande, and Marlies Ostermann.
• Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. mortenhylander@gmail.com.
• Intensive Care Med. 2022 Jul 1; 48 (7): 801810801-810.

PurposeThe aim of this Intensive Care Medicine Rapid Practice Guideline (ICM‑RPG) was to formulate evidence‑based guidance for the use of dexmedetomidine for sedation in invasively mechanically ventilated adults in the intensive care unit (ICU).MethodsWe adhered to the methodology for trustworthy clinical practice guidelines, including use of the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of evidence, and the Evidence-to-Decision framework to generate recommendations. The guideline panel comprised 28 international panelists, including content experts, ICU clinicians, methodologists, and patient representatives. Through teleconferences and web‑based discussions, the panel provided input on the balance and magnitude of the desirable and undesirable effects, the certainty of evidence, patients' values and preferences, costs and resources, feasibility, acceptability, and research priorities.ResultsThe ICM‑RPG panel issued one weak recommendation (suggestion) based on overall moderate certainty of evidence: "In invasively mechanically ventilated adult ICU patients, we suggest using dexmedetomidine over other sedative agents, if the desirable effects including a reduction in delirium are valued over the undesirable effects including an increase in hypotension and bradycardia".ConclusionThis ICM-RPG provides updated evidence-based guidance on the use of dexmedetomidine for sedation in mechanically ventilated adults, and outlines uncertainties and research priorities.© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.

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