Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebo-controlled trial

This US study (n=798) found no benefit for perioperative dexmedetomidine infusion in cardiac surgery patients, in terms of incidence of post-operative AF (30% v 34% with placebo) or delirium (17% v 12%; neither difference statistically significant).

SPS commentary:

A related comment states that based on the results of this study (DECADE), dexmedetomidine should be used cautiously in patients who have cardiac surgery to minimise the associated occurrence of intraoperative arterial hypotension and should not be given with the expectation of reducing atrial fibrillation or delirium. They suggest that prevention of these complications cannot be achieved with a single ‘magic bullet’; instead it requires multidisciplinary teamwork throughout various phases of the perioperative setting.


The Lancet

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