Dexmedetomidine did not significantly impact ICU length of stay compared with propofol, but it significantly reduced the duration of mechanical ventilation and the risk of delirium in cardiac surgical patients. It also significantly increased the risk of bradycardia across ICU patient subsets.

41 trials (N=3948) were included.

Dexmedetomidine did not significantly affect ICU length of stay across any ICU patient subtype when compared with propofol, but it reduced the duration of mechanical ventilation (mean difference −0.67 h; 95% confidence interval: −1.31 to −0.03 h; P=0.041; low certainty) and the risk of ICU delirium (risk ratio 0.49; 95% confidence interval: 0.29–0.87; P=0.019; high certainty) across cardiac surgical patients.

Dexmedetomidine was also associated with a greater risk of bradycardia across a variety of ICU patients.

Subgroup analyses revealed that age might affect the incidence of hemodynamic side-effects and mortality among cardiac surgical and medical/other surgical patients.

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