Dexmedetomidine for sedation during noninvasive ventilation in COVID-19 patients from the Helmet-COVID randomized clinical trial post-hoc analysis

and degree of hypercapnia were largely comparable between both groups. During the ICU stay, dexmedetomidine-treated patients were more likely to have received helmet NIV (70 of 107, 65.4%), awake proning (45 of 107, 42.1%), vasopressors and renal replacement therapy (57.9 and 17.8%, respectively). Dexmedetomidine-treated patients had higher ICU and hospital mortality, higher intubation rate, and fewer ICU-free days compared to those not receiving dexmedetomidine; differences that could not be fully explained by confounding alone. There were no significant differences in HRQoL outcomes at 180 days. Median EQ-5D-5L index values and EQ-VAS median scores showed no significant differences between the dexmedetomidine and non-dexmedetomidine groups. Among patients with COVID-19-induced acute hypoxemic respiratory failure managed with NIV, dexmedetomidine use was common. Dexmedetomidine-treated patients had a different disease trajectory than non-dexmedetomidine-treated patients. The worse outcomes observed with dexmedetomidine were not entirely explained by differences in baseline characteristics, suggesting effects of time-varying confounders. Randomized controlled trials are required to assess effects of dexmedetomidine on patient-centered outcomes.Trial registration: NCT04477668; registered on July 20, 2020.

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Publication Details

Journal
Scientific Reports
Published
2026-05-09
DOI
https://doi.org/10.1038/s41598-026-49301-9
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
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0.00

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article

Dexmedetomidine for sedation during noninvasive ventilation in COVID-19 patients from the Helmet-COVID randomized clinical trial post-hoc analysis

Mohammed Alobaidi, Jesna Jose, Omar Al Zumai, K Lewis et al.
Scientific Reports
Intensive Care Unit Cognitive Disorders
article

Dexmedetomidine for sedation during noninvasive ventilation in COVID-19 patients from the Helmet-COVID randomized clinical trial post-hoc analysis

Mohammed Alobaidi, Jesna Jose, Omar Al Zumai, K Lewis, Ayman Kharaba, Abdulaziz Al Dawood, Mohammed K. Al Harbi, Zainab Al Duhailib, Saad Al Qahtani, Sara Aldekhyl, Eman Al Qasim, Awad Al-Omari, Mohammed S. Alshahrani, Marwa Amer, Sheryl Ann Abdukahil, Mohammed Al Mutairi, Abdulrahman A. Al-Fares, Haytham Tlayjeh, Ahmed Alaqeily, Haifa Algethamy, Yaseen M. Arabi, Hussain Al Haji, Lolowa M. Alswaidan, Samiyah Alrawy Alanazi, Abdullah M. Altamimi, Zohair Al Aseri, Hasan M. Al-Dorzi, Ali Al Bshabshe, Ahmed Mady, Talal Albrahim
article en

Abstract

and degree of hypercapnia were largely comparable between both groups. During the ICU stay, dexmedetomidine-treated patients were more likely to have received helmet NIV (70 of 107, 65.4%), awake proning (45 of 107, 42.1%), vasopressors and renal replacement therapy (57.9 and 17.8%, respectively). Dexmedetomidine-treated patients had higher ICU and hospital mortality, higher intubation rate, and fewer ICU-free days compared to those not receiving dexmedetomidine; differences that could not be fully explained by confounding alone. There were no significant differences in HRQoL outcomes at 180 days. Median EQ-5D-5L index values and EQ-VAS median scores showed no significant differences between the dexmedetomidine and non-dexmedetomidine groups. Among patients with COVID-19-induced acute hypoxemic respiratory failure managed with NIV, dexmedetomidine use was common. Dexmedetomidine-treated patients had a different disease trajectory than non-dexmedetomidine-treated patients. The worse outcomes observed with dexmedetomidine were not entirely explained by differences in baseline characteristics, suggesting effects of time-varying confounders. Randomized controlled trials are required to assess effects of dexmedetomidine on patient-centered outcomes.Trial registration: NCT04477668; registered on July 20, 2020.

Scientific Reports
Alfaisal University (SA), King Abdulaziz University (SA), King Saud bin Abdulaziz University for Health Sciences (SA), Tanta University (EG), King Faisal Specialist Hospital & Research Centre (SA), King Saud Medical City (SA), King Fahd Hospital of the University (SA), King Saud University (SA), King Abdulaziz Medical City (SA), Amiri Hospital (KW), King Abdullah International Medical Research Center (SA), Ministry of Health (KW), King Fahad Hospital Jeddah (SA), Impact (CA), Asir Central Hospital (SA), National Guard Health Affairs (SA), Imam Abdulrahman Bin Faisal University (SA), King Khalid University (SA), McMaster University (CA)
King Abdullah International Medical Research Center
Good health and well-being
Openalex Percentile: Top 7%
Intensive Care Unit Cognitive Disorders
DOIOpen Access PDFOpenAlex
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