Timothy Simon Walsh, Leanne M Aitken, Cathrine A McKenzie, Julia Boyd, Alix Macdonald, Annabel Giddings, David Hope, John Norrie, Christopher Weir, Richard Anthony Parker, Nazir I Lone, Lydia Emerson, Kalliopi Kydonaki, Benedict Creagh-Brown, Stephen Morris, Daniel Francis McAuley, Paul Dark, Matt P Wise, Anthony C Gordon, Gavin Perkins, Michael Reade, Bronagh Blackwood, Alasdair MacLullich, Robert Glen, Valerie J Page
INTRODUCTION: Almost all patients receiving mechanical ventilation (MV) in intensive care units (ICUs) require analgesia and sedation. The most widely used sedative drug is propofol, but there is uncertainty whether alpha2-agonists are superior. The alpha 2 agonists for sedation to produce better outcomes from critical illness (A2B) trial aims to determine whether clonidine or dexmedetomidine (or both) are clinically and cost-effective in MV ICU patients compared with usual care. METHODS AND ANALYSIS: Adult ICU patients within 48 hours of starting MV, expected to require at least 24 hours further MV, are randomised in an open-label three arm trial to receive propofol (usual care) or clonidine or dexmedetomidine as primary sedative, plus analgesia according to local practice...
December 10, 2023: BMJ Open