• Laura Pasin, Teresa Greco, Paolo Feltracco, Annalisa Vittorio, Caetano Nigro Neto, Luca Cabrini, Giovanni Landoni, Gabriele Finco, and Alberto Zangrillo.
• Anesthesia and Intensive Care Department, San Raffaele Scientific Institute, Milan, Italy.
• Plos One. 2013 Jan 1;8(12):e82913.

IntroductionThe effect of dexmedetomidine on length of intensive care unit (ICU) stay and time to extubation is still unclear.Materials And MethodsPertinent studies were independently searched in BioMedCentral, PubMed, Embase, and the Cochrane Central Register of clinical trials (updated February first 2013). Randomized studies (dexmedetomidine versus any comparator) were included if including patients mechanically ventilated in an intensive care unit (ICU). Co-primary endpoints were the length of ICU stay (days) and time to extubation (hours). Secondary endpoint was mortality rate at the longest follow-up available.ResultsThe 27 included manuscripts (28 trials) randomized 3,648 patients (1,870 to dexmedetomidine and 1,778 to control). Overall analysis showed that the use of dexmedetomidine was associated with a significant reduction in length of ICU stay (weighted mean difference (WMD) = -0.79 [-1.17 to -0.40] days, p for effect <0.001) and of time to extubation (WMD = -2.74 [-3.80 to -1.65] hours, p for effect <0.001). Mortality was not different between dexmedetomidine and controls (risk ratio = 1.00 [0.84 to 1.21], p for effect = 0.9). High heterogeneity between included studies was found.ConclusionsThis meta-analysis of randomized controlled studies suggests that dexmedetomidine could help to reduce ICU stay and time to extubation, in critically ill patients even if high heterogeneity between studies might confound the interpretation of these results.

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