This single-centre retrospective cohort included 245 adult ICU patients with echocardiographic right ventricular dysfunction who received dexmedetomidine between 2017 and 2022. After initiation, 153 patients (62.4%) experienced at least one composite adverse event: bradycardia, hypotension, increased vasopressor/inotrope requirements, or asystole. Hypotension occurred in 129 patients, while increased vasopressor requirements occurred in 35; the mean change in norepinephrine equivalents from baseline was 0.06 µg/kg/min. Reported adverse-event rates did not differ across mild, moderate, and severe right ventricular dysfunction, but the abstract provides no effect estimates or uncertainty for this comparison.
Haemodynamic adverse events were common after dexmedetomidine initiation in this cohort. Without a comparator, these findings cannot establish drug-attributable risk or comparative sedative safety.
Study limitation: The single-centre retrospective design and absence of a comparator limit causal interpretation; reported hypotension and vasopressor percentages have unclear denominators.
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