Dexmedetomidine to Reduce Vasopressor Resistance in… : Critical Care Medicine
ilot study aimed to evaluate the effect of dexmedetomidine on the vasopressor response in patients with refractory septic shock. DESIGN: This study was a multicenter, randomized, placebo-controlled, double-blind pilot trial. SETTING: The study was conducted in 5 ICUs in France. PATIENTS: Inclusion criteria were septic shock (Sepsis-3 definition) and norepinephrine requirement greater than or equal to 0.25 µg/kg/min (0.5 µg/kg/min of norepinephrine tartrate) with persistent circulatory failure (defined by lactate > 2 mmol/L, oliguria, or skin mottling) and invasive mechanical ventilation. INTERVENTIONS: The arterial pressure response to phenylephrine was measured before starting the treatment (0 hr), at 6 hours (primary outcome), and 12 hours. In the treatment arm, dexmedetomidine was given at a fixed dose of 1 µg/kg/hr. MEASUREMENTS AND MAIN RESULTS: Inclusions were stopped early because of higher mortality in the dexmedetomidine arm. Thirty-two patients of the 36 planned were included
