Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery

The randomized DECADE study evaluated whether dexmedetomidine lowers the risk of atrial fibrillation and delirium, two common complications of cardiac surgery. U.S. researchers recruited about 800 patients from six academic hospitals from April 2013 to December 2018. Participants were allocated in a 1:1 ratio to receive either dexmedetomidine infusion or normal saline placebo at anesthesia induction, lasting until 24 hours postoperatively. Atrial fibrillation occurred between ICU admission and postoperative day 5 or hospital discharge—whichever was first—in 30% of the dexmedetomidine group and 34% of the control group. Delirium presented in 17% and 12%, respectively. Neither difference was considered significant; therefore, the study authors concluded that dexmedetomidine should not be administered with the aim of reducing atrial fibrillation or delirium in patients after cardiac surgery.