A Pilot Study of Effect of Dexmedetomidine on Sleep and Inflammation in Critically Ill Patients
A Pilot Study of Effect of Dexmedetomidine on Sleep and Inflammation in Critically Ill Patients
The purpose of this study is to assess the short-term effect of sympatholysis on sleep
 quality and inflammation in critically ill patients.
Over 1 million patients receive mechanical ventilation every year in the United States. In
 mechanically ventilated patients, despite sedative infusions, sleep is severely disrupted.
 Sleep disruption, in turn, can lead to activation of sympathetic nervous system and elevated
 inflammatory cytokines. Both sympathetic hyperactivity and elevated cytokines have been
 associated with delirium, which, in turn, is associated with increased mortality and higher
 healthcare costs. Currently, however, there is very little understanding of the
 inter-relationship between critical illness, sleep, and neuropsychological well-being. The
 purpose of this study is to collect preliminary data on the short-term effects of sedation
 with and without sympatholysis on sleep and inflammation in critically ill patients receiving
 mechanical ventilation. This pilot study will be accomplished by performing sleep studies and
 circulating cytokine measurements in critically ill patients randomized to receive two
 different sedation strategies: Dexmedetomidine versus Midazolam and Fentanyl. The ultimate
 goal of this program of research is to identify sedation practices that are least associated
 with adverse short- and long-term consequences, and thereby ultimately help improve sleep
 quality and quality of life in patients surviving critical illness.
Inclusion Criteria:

 -  Patients requiring mechanical ventilation with a diagnosis of

 -  Acute Respiratory Distress Syndrome

 -  Cardiogenic Pulmonary Edema

 -  Pneumonia

 -  Chronic obstructive pulmonary disease

 Exclusion Criteria:

 -  Patients who are considered too unstable to undergo this investigation by their
 primary physician

 -  Comatose patients, or patients with severe debilitating neurological disease

 -  Renal insufficiency (Sr. Creatinine > 2 mg/dL)

 -  Heart block (second or third degree heart block) or sinus bradycardia (heart rate < 60
 beats per minute)

 -  Pregnancy