Objective  To rapidly evaluate the efficacy, safety, and economics of dexmedetomidine in patients on mechanical ventilation in intensive care unit (ICU), and to provide references for clinical and decision makers.

Methods  To search PubMed, Embase, Cochrane Library, CNKI, WanFang Data databases and official websites of domestic and foreign Health Technology assessment (HTA) institutions from the inception to June 14, 2023. HTA reports, systematic reviews/Meta-analyses, and pharmacoeconomic studies of patients with mechanical ventilation in ICU compared with dexmedetomidine versus placebo or other traditional sedatives were included. Two reviewers independently identified studies, extracted data, assessed the quality of included studies, and descriptive analyzed and summarised the results.

Results  A total of 13 literatures were included, including 10 systematic reviews/Meta-analyses and 3 economic studies. The analysis results of effectiveness showed that compared with placebo or other traditional sedatives, the use of dexmedetomidine in the sedation of mechanically ventilated patients in the ICU was associated with a shorter duration of mechanical ventilation and a shorter length of stay in the ICU. The analysis results of safety displayed treatment with dexmedetomidine could reduce the incidence of delirium, but may increase the incidence of bradycardia. The results of the economic analysis showed that the dexmedetomidine group had a higher cost of medication, but a lower overall ICU cost.

Conclusion  Dexmedetomidine has good efficacy, safety and economics in the sedation of patients on mechanical ventilation in ICU, but the economic studies included in the search were mainly foreign studies, and domestic economy studies needs to be further demonstrated.

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