Shehabi Y, et al. - Researchers conducted this open-label, randomized trial to further study the use of dexmedetomidine as the sole or primary sedative agent in patients undergoing mechanical ventilation. They recruited critically ill adults who had undergone intensive care unit (ICU) ventilation for < 12 hours and were expected to continue receiving dexmedetomidine as a single or primary sedative or usual care (propofol, midazolam, or other sedatives) for longer than the next calendar day. A total of 4,000 patients were included in the study. Among patients undergoing mechanical ventilation at the ICU, patients receiving early dexmedetomidine for sedation had a 90-day death rate similar to that in the usual-care group, and required additional sedatives to achieve the prescribed sedation level. In the dexmedetomidine group, more adverse events were reported than in the usual-care group. In the dexmedetomidine group, bradycardia and hypotension were more common.