To the Editor: For the randomized trial of dexmedetomidine vs midazolam for sedation of critically ill patients by Dr Riker and colleagues,1 the US Food and Drug Administration (FDA) approved dexmedetomidine for up to 30 days of mechanical ventilation. The authors reported no death related to dexmedetomidine when administered at doses greater than 1.4 μg/kg per hour for days in a cohort of patients who were predominately (276/366, 75%) in severe sepsis.
Rady MY, Patel BM, Larson JS. Comparing Dexmedetomidine With Midazolam for Sedation of Patients in the ICU. JAMA. 2009;301(23):2439-2442. doi:10.1001/jama.2009.837