Case Report

Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine

Åsa Engström*, Maria Johansson, Mia Mattsson and Ulrica Strömbäck

Published: 22 December, 2016 | Volume 1 - Issue 1 | Pages: 005-013

Background: Intensive care patients are often in need of sedation to endure being intubated. Light sedation is increasingly common since it has been proved to offer benefits such as faster recovery to patients.

Aim: The aim of this study was to describe critical care nurses’ experiences of nursing patients lightly sedated with dexmedetomidine.

Research Methodology: Qualitative personal interviews were conducted during 2015 with 10 critical care nurses in Sweden. Interview transcripts were analysed using inductive qualitative thematic analysis.

Results: Light sedation of the patient facilitated communication and interaction with him or her, and the relationship between the patient and his or her family members. Dexmedetomidine was described as a fairly new drug, and the critical care nurses stated that they needed more knowledge about it and about sedation scales in order to learn more about the drug’s mechanism of action and its potential side effects on patients.

Conclusion: It is important to critical care nurses to learn more about dexmedetomidine and about sedation scales to assess levels of sedation, as light sedation has been shown to benefit the patient as opposed to deep sedation that can increase recovery time.

Read Full Article HTML DOI: 10.29328/journal.jcicm.1001002 Cite this Article Read Full Article PDF


Critical care nurses; Experiences; Intensive care; Qualitative content analysis; Sedation


  1. Hoy SM, Keating GM. Dexmedetomidine: A review of its use for sedation in mechanically ventilated patients in an intensive care setting and for procedural sedation. Drugs. 2011; 71: 1481-1501. Ref.: https://goo.gl/9RLMsb
  2. Aitken L, Marshall A, Chaboyer W. ACCCN's Critical Care Nursing. Elsevier Health Sciences. 2016. Ref.: https://goo.gl/J4tyT9
  3. Fullwood D, Sargent S. An overview of sedation for adult patients in hospital. Nurs Stand. 2010; 24: 48-56. Ref.: https://goo.gl/JK49gC
  4. Croxall C, Tyas M, Garside J. Sedation and its psychological effects following intensive care. Br J Nurs. 2014; 23: 800-804. Ref.: https://goo.gl/ZibH5p
  5. Makic MBF. Daily sedation interruption: current state of the science. Journal of Perianesth Nursing. 2014; 29: 501-503. Ref.: https://goo.gl/lYUUTo
  6. Dotson B. Daily interruption of sedation in patients treated with mechanical ventilation. Am J Health Syst Pharm. 67: 1002-1006. Ref.: https://goo.gl/vVkgtK
  7. Sessler C, Gosnell M, Grap M, Brophy G, O'Neal P, et al. The Richmond Agitation-Sedation Scale: Validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002; 166: 1338-1344. Ref.: https://goo.gl/tM0xcm
  8. Short J. Use of Dexmedetomine for primary sedation in a general intensive care unit. Crit Care Nurse. 2010; 30: 29-38. Ref.: https://goo.gl/3cK3k3
  9. Samuelson K, Lundberg D, Fridlund B. Stressful experiences in relation to depth of sedation in mechanically ventilated patients. Nurs Crit Care. 2007; 12: 93-104. Ref.: https://goo.gl/KMuwz9
  10. Engström Å, Nyström N, Sundelin G, Rattray J. People's experiences of being mechanically ventilated in an ICU: A qualitative study. Intensive Crit Care Nurs. 2013; 29: 88-95. Ref.: https://goo.gl/B2xvmM
  11. Egerod I, Christensen BV, Johansen L. Nurses’ and physicians’ sedation practices in Danish ICUs in 2003. A national survey. Intensive Crit Care Nurs. 2006; 22: 22-31. Ref.: https://goo.gl/5k70V7
  12. Walker N, Gillen P. Investigating nurses’ perceptions of their role in managing sedation in intensive care: An exploratory study. Intensive Crit Care Nurs. 2006; 22: 338-345. Ref.: https://goo.gl/hCg3OJ
  13. Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013; 41: 263-306. Ref.: https://goo.gl/70Gp3b
  14. Ely E, Truman B, Shintani A, Thomason J, Wheeler A, et al. Caring for the critically ill patient. Monitoring sedation status over time in ICU patients: Reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003; 289: 2983-2991. Ref.: https://goo.gl/Df6e7W
  15. Samuelson K. Sedation during mechanical ventilation in intensive care: Sedation practices and patients’ memories, stressful experiences and psychological distress. Doctoral diss, Lund University, Sweden. 2006. Ref.: https://goo.gl/WMMCrF
  16. Gerlach AT, Murphy CV, Dasta JF. An updated focused review of dexmedetomidine in adults. Ann Pharmacother. 2009; 43: 2064-2074. Ref.: https://goo.gl/hk3W8l
  17. Szumita PM, Baroletti SA, Anger KE, Wechsler ME. Sedation and analgesia in the intensive care unit: Evaluating the role of dexmedetomidine. Am J Health Syst Pharm. 2007; 64: 37-44. Ref.: https://goo.gl/fqwMa3
  18. Keating GM. Dexmedetomidine: a review of its use for sedation in the intensive care setting. Drugs. 2015; 75: 1119-1130. Ref.: https://goo.gl/zZZAXV
  19. Cruickshank M, Henderson L, MacLennan G, Fraser C, Campbell M, et al. Alpha-2 agonists for sedation of mechanically ventilated adults in intensive care units: a systematic review. Health Technol Assess. 2016; 20: 1-117. Ref.: https://goo.gl/PeBWlv
  20. FASS (Pharmaceutical Specialities in Sweden). Dexmedetomidine. Ref.: https://goo.gl/M0QqRc
  21. Patton MQ. Qualitative research & evaluation methods (4th ed.) London: SAGE. 2015.
  22. Polit DF, Beck CT. Nursing research: Generating and assessing evidence for nursing practice. (9th ed.) Philadelphia: Lippincott Williams and Wilkins. (2017). Ref.: https://goo.gl/Mh2XBH
  23. Kvale S, Brinkmann S. Den kvalitativa forskningsintervjun [The qualitative research interview]. 3th ed. Lund: Studentlitteratur. 2014. Ref.: https://goo.gl/CiMVcu
  24. SFS 2003:460. Svensk författningssamling [Swedish Code of Statutes]. Ref.: https://goo.gl/8lmX7c
  25. Roberts M, Johnson LA, Lalonde TL. Early mobility in the intensive care unit: Standard equipment vs a mobility platform. Am J Crit Care. 2014; 23: 451-457. Ref.: https://goo.gl/IMRNK9
  26. De Jonghe B, Bastuji-Garin S, Durand M, Malissin I, Rodrigues P, et al. Respiratory weakness is associated with limb weakness and delayed weaning in critical illness. Crit Care Med. 2007;35: 2007-2015. Ref.: https://goo.gl/SQ7biS
  27. Dasta J, Kane-Gill S, Pencina M, Shehabi Y, Bokesch P, et al. A cost-minimization analysis of dexmedetomidine compared with midazolam for long-term sedation in the intensive care unit. Crit Care Med. 2010;38: 497-503. Ref.: https://goo.gl/mO3KQw
  28. Shehabi Y, Bellomo R, Reade MC, Bailey M, Bass F, et al. Early goal-directed sedation versus standard sedation in mechanically ventilated critically ill patients: A pilot study. Crit Care Med. 2013; 41: 1983-1991. Ref.: https://goo.gl/eFkwdh
  29. Karlsson V. Att vårdas vaken med respirator: Patienters och närståendes upplevelser från en intensivvårdsavdelning [Being nursed awake with respiratory: Patients’ and their relatives’ experiences from an intensive care unit]. Doctoral thesis, University of Gothenburg, Sweden. 2012. Ref.: https://goo.gl/IW6eUH
  30. Laerkner E, Egerod C, Ploug H. Nurses’ experiences of caring for critically ill, non-sedated, mechanically ventilated patients in the Intensive Care Unit: A qualitative study. Intensive Crit Care Nurs. 2015; 31: 196-204. Ref.: https://goo.gl/ZxpTcq
  31. Eriksson K. Pausen: En beskrivning av vårdvetenskapens kunskapsobjekt [The pause: A description of health science knowledge objects]. Stockholm: Almqvist and Wiksell. 1987.
  32. Engström Å, Söderberg S. The experiences of partners of critically ill persons in an intensive care unit. Intensive Crit Care Nurs. 2004; 20: 299-308. Ref.: https://goo.gl/832YGc
  33. Pang P, Suen L. Stressors in the ICU: A comparison of patients’ and nurses’ perceptions. J Clin Nurs. 2008; 17: 2681-2689. Ref.: https://goo.gl/BSj8vE
  34. Tanios M, Epstein S, Grzeskowiak M, Nguyen HM, Hyunsoon P, et al. Influence of sedation strategies on unplanned extubation in a mixed intensive care unit. Am J Crit Care. 2014; 23: 306-315. Ref.: https://goo.gl/ZGqYTn
  35. Egerod I. Uncertain terms of sedation in ICU. How nurses and physicians manage and describe sedation for mechanically ventilated patients. J Clin Nurs. 2002; 11: 831-840. Ref.: https://goo.gl/eBjeaC
  36. Beck L, Johnson C. Implementation of a nurse-driven sedation protocol in the ICU. Dynamics. 2008; 19: 25-28. Ref.: https://goo.gl/vRydeu
  37. SFS 1982:763. Hälso- och sjukvårdslag [Swedish Health Care Act]. Ref.: https://goo.gl/fZDdG9
  38. SFS 2001:453. Hälso- och sjukvårdslag [Swedish Health Care Act]. Ref.: https://goo.gl/VAmtEV


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