New sedative trial aims to cut delirium and save lives in elderly ICU patients

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age ≥ 65 years 2. Intubated and receiving invasive mechanical ventilation in an intensive care unit 3. The treating clinicians believe that the patient will remain intubated and ventilated until the day after tomorrow (i.e. unlikely to be extubated the following day) 4. The patient requires immediate ongoing sedative medication for comfort, safety and to facilitate the delivery of life support measures. Exclusion Criteria: 1. Has been intubated (excluding time spent intubated within an operating theatre or transport) for greater than 12 hours, with an additional 6-hour grace period, a total of 18 hours, in an intensive care unit 2. Proven or suspected acute primary brain lesion such as traumatic brain injury, haemorrhage, stroke, or hypoxic brain injury 3. Proven or suspected spinal cord injury or other pathology that may result in permanent or prolonged weakness 4. Admission as a consequence of a suspected or proven drug overdose or burns 5. Administration of or need for ongoing neuromuscular blockade 6. A mean arterial blood (MAP) pressure that is less than 50 mmHg, despite adequate resuscitation and vasopressor support at time of randomization 7. Heart rate less than 55 beats per minute or a high grade atrio-ventricular block in the absence of a functioning pacemaker 8. Known sensitivity to dexmedetomidine 9. Acute fulminant hepatic failure with EITHER 1. hepatic encephalopathy OR 2. bilirubin (\>300 µmol/l) and INR (\>3.5), or both, without prior hepatic dysfunction. 10. Receiving full time residential nursing care 11. Death is deemed both imminent and inevitable and either the attending physician, patient or substitute decision maker is not committed to active treatment 12. Underlying disease that makes survival to 90 days unlikely 13. Previously enrolled in the SPICE IV study