The pronounced prevalence of
delirium in geriatric patients admitted to the intensive care unit (ICU) and its increased morbidity and mortality is a well-established phenomenon. The purpose of this review is to explore the potential use of
dexmedetomidine in preventing or managing ICU
delirium in older patients. Articles used were identified and selected through multiple search engines, including Google Scholar, PubMed, and MEDLINE. Keywords such as
dexmedetomidine,
delirium, geriatric, ICU
delirium,
delirium in elderly, and palliative were used to obtain the specific articles used for this paper and restricted to articles published in 1990 or later. Articles specifically looking at the use of
dexmedetomidine as compared to a study
drug and its potential for use in ICU patients, as opposed to overall reviews of
dexmedetomidine, were compared. When compared to
benzodiazepines for the prevention or treatment of ICU
delirium in the elderly,
dexmedetomidine was associated with a reduction in
delirium, as well as decreased morbidity and mortality.
Dexmedetomidine has also been shown to be effective in limiting risk factors associated with ICU
delirium such as length and depth of sedation. As opposed to
benzodiazepines or
opiates,
dexmedetomidine provides effective
analgesia, sympatholysis, and anxiolysis without causing
respiratory depression and allows a patient to more effectively interact with practitioners. The review of these nine articles indicates that these favorable attributes and overall decreased duration and incidence of
delirium make
dexmedetomidine a viable option in preventing or reducing ICU
delirium in high-risk geriatric patients and as a palliative adjunct to help control symptoms and stressors.