Adjunct Dexmedetomidine (Precedex®) Therapy Impact on Sedative and Analgesic Requirement

Patients identified by selection criteria within 48 hours of intubation will be randomly
assigned to one of three study arms: dexmedetomidine 0.2 mcg/kg/hr, dexmedetomidine 0.6
mcg/kg/hr, or placebo. If not already on, patients will be converted to propofol and
fentanyl for sedation and analgesia, which will be titrated to a goal SAS score of 3-4.

Patients will be monitored, assessed, and evaluated by all regular policies and procedures
of the institution. Extubation will be at the discretion of the physicians and medical team
caring for the patient. If the patient is still intubated at five days study drug will then
be stopped and further use of dexmedetomidine will be at the discretion of the physicians.

Primary objective will assess impact of increasing dose of dexmedetomidine on total daily
dose of fentanyl and propofol while maintaining sedation in a mechanically ventilated
patient in a general medical intensive care unit.

Secondary objectives include total ventilation time, ICU length of stay, hospital length of
stay, patient outcomes/mortality, and total pharmacy expenditures.