MedicalResearch.com Interview with:
Yahya Shehabi PhD, FANZCA, FCICM, EMBA, GAICD
Director of Research, Critical Care and Peri-operative Medicine, Monash Health
Professor, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University
Professor Intensive Care Medicine, Clinical School of Medicine, University New South Wales
Critical Care and Peri-Operative Medicine Lead – Monash Health Translational Precinct
MedicalResearch.com: What is the background for this study?
Response: SPICE III was the final phase of a series of SPICE studies. SPICE I showed 2 important findings,
first, deep sedation in the first 48 hours is strongly associated with higher mortality, longer ventilation time and higher risk of delirium.
Second; that Dexmedetomidine is mainly used as an adjunct secondary agent 3-4 days after commencing mechanical ventilation and not as a primary sedative agent. In addition, albeit with several limitations, previous RCTs comparing Dexmedetomidine with conventional sedatives showed reduced iatrogenic coma, shortened ventilation time and reduced delirium with Dexmedetomidine treatment.
So based on the above we hypothesized that using Dexmedetomidine soon after commencing ventilation as a primary sedative agent, through reducing early iatrogenic coma, ventilation time and delirium, would impact 90 day-mortality.
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