Association of early dexmedetomidine administration with the risk of ARDS in sepsis patients during ICU stay: results from MIMIC-IV.

Background: This study sought to investigate the relationship between early administration of dexmedetomidine (DEX) and the risk of acute respiratory distress syndrome (ARDS) in sepsis patients in the intensive care unit (ICU).

Method: The study was a retrospective cohort study. We extracted and obtained data on sepsis patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary exposure of interest was the administration of DEX, and the primary outcome was the occurrence of ARDS. Univariable and multivariable Logistic regression analyses were conducted to adjust for confounding factors.

Results: A total of 6,220 sepsis patients were included in the study, of which 1,071 (17.22%) developed ARDS. Multivariable logistic regression analysis revealed that early administration of DEX was associated with a lower risk of ARDS [odds ratio (OR) = 0.74, 95% confidence interval (CI): 0.55-0.99]. Additionally, compared to sepsis patients who did not receive DEX, those with shorter durations of DEX treatment had a lower risk of developing ARDS (OR = 0.54, 95% CI: 0.34-0.85). Subgroup analysis indicated that among sepsis patients younger than 65 years old, males, and those without comorbidities (hypertension, diabetes, chronic kidney disease), a shorter duration of DEX use was associated with a lower risk of ARDS in sepsis patients.

Conclusion: The early administration of DEX was associated with the risk of ARDS in sepsis patients within 24 hours of ICU admission, suggesting that DEX may play a significant role in the health management of sepsis patients.