Dexmedetomidine in the Care of Critically Ill Patients from 2001 to 2007
Bibliographic record
Abstract
BACKGROUND: Dexmedetomidine is a novel sedative agent that causes anxiolysis without respiratory depression in critically ill patients. We sought to examine patient and hospital variation in dexmedetomidine use and adoption patterns of dexmedetomidine over time. METHODS: We performed a retrospective cohort study of all patients who received intravenous infusion sedation in 174 intensive care units contributing data to Project IMPACT from 2001 through 2007. Sedation use was defined as having received an intravenous sedative infusion (dexmedetomidine, midazolam, lorazepam, or propofol) for any period during the intensive care stay. The primary outcome was use of dexmedetomidine in the intensive care unit. RESULTS: Of 58,391 patients who received intravenous infusion sedation, 2,535 (4.3%, 95% confidence interval [CI], 4.2-4.5) received dexmedetomidine. Overall use was highest in cardiac surgery patients (11.7%, 10.8-12.7) and was similar in other surgical patients (4.3%, 4.0-4.6) and medical patients (3.4%, 3.2-3.6, P < 0.001). Use of dexmedetomidine increased from 2.0% (1.6-2.4) of patients receiving intravenous infusion sedation in 2001 to 7.2% (6.6-7.9) in 2007 (P < 0.001), primarily because of an increase in use in cardiac surgery patients (1.4%, 0.0-2.8, in 2001 vs. 20.2%, 17.6-22.8 in 2007, P < 0.001). Of the patients who received dexmedetomidine, 31.5% (29.6-33.3) received the infusion for more than 1 day, and 10.9% were not mechanically ventilated. CONCLUSION: Use of dexmedetomidine in critically ill patients has increased over time, primarily as a result of an increase in use among cardiac surgery patients. A substantial portion of dexmedetomidine was administered outside of the regulatory approval guidelines at the time.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".