Dexmedetomidine and Propofol Sedation in Critically Ill Patients: How Much Is Too Much?

A study was conducted post hoc analysis of the SPICE-III trial to explore the association between different drug dose scenarios and 90-day mortality. The study found that increasing mean propofol infusion rates with steady mean dexmedetomidine infusion was associated with reduced mortality for younger patients (<65 years old). Conversely, increasing mean dexmedetomidine infusion rates with steady mean propofol was associated with increased mortality in younger patients. The study did not find any association between increasing dexmedetomidine infusion rates and steady mean propofol or vice versa and 90-day mortality for patients over 65 years. However, there are some limitations to the interpretation of the findings, and unmeasured confounding should be considered.