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Highly Accessed Open Badges Letter

Safety of dexmedetomidine sedation in postoperative cardiac surgery patients

Fu-Shan Xue*, Yi Cheng and Rui-Ping Li

Author Affiliations

Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, People's Republic of China 100144

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Critical Care 2013, 17:435  doi:10.1186/cc12724

See related research by Lin et al.,

Published: 11 June 2013

First paragraph (this article has no abstract)

In a meta-analysis regarding efficacy and safety of dexmedetomidine sedation in postoperative cardiac surgery patients [1], Lin and colleagues' conclusion that dexmedetomidine may decrease the risk of hyperglycemia is questionable. In their meta-analysis of hyperglycemia in Figure 3 of their report, three articles regarding the use of dexmedetomidine sedation after cardiac surgery are cited [2-4]. In the study of Abd Aziz and colleagues [2], however, postoperative glucose level was not assessed as an end point. Shehabi and colleagues [3] showed that incidence of hyperglycemia (blood sugar level >10 mmol/L) was not significantly different between dexmedetomidine and morphine groups (36.8% versus 47.6%, P = 0.062). Herr and colleagues [4] demonstrated that the incidence of treatment-emergent hyperglycemia reaction was similar between dexmedetomidine and propofol groups (3% versus 3%, P = 0.750). Furthermore, a recent meta-analysis indicates that dexmedetomidine does not decrease risk of hyperglycemia compared with the traditional sedative and analgesic agents in critically ill adult patients [5]. Thus, we are concerned about this incorrect conclusion of Lin and colleagues on the effect of dexmedetomidine on blood glucose level.