Table 2.

The rationale for the use of dexmedetomidine in the clinical scenarios does not properly cope by the current pain, agitation and delirium strategies. The ballot for each rationale is also reported

Clinical scenarios	Rationale for dexmedetomidine use	Appropriate	Inappropriate	Uncertain
Medical patients
Weaning from sedation in patients with prolonged mechanical ventilation (>72 h)	DEX does not impair respiratory drive	17	0	0
	DEX improves the comfort and interaction with the environment	17	0	0
Underlying degenerative cerebral diseases	DEX reduces the occurrence of delirium and exerts protective effects on cognitive function	17	0	0
Weaning from sedation in patients with substance abuse	DEX reduces neurovegetative response to stress	15	0	2
Patients undergoing NIV
Dose-dependent respiratory drive depression induced by current sedatives	DEX does not impair respiratory drive	17	0	0
Airway control in sedated patients undergoing NIV	DEX allows better upper airway protection and reduces the occurrence of bronchoconstriction	17	0	0
Risk of oversedation and difficulties in obtaining a light sedation level	DEX pharmacodynamics reduces the risk of oversedation	14	0	3
Sleep disturbances	DEX improves sleep quality, mimicking natural electroencephalography pattern	16	0	1
Intolerance to NIV in patients with agitation/delirium	DEX improves the comfort and interaction with the environment	17	0	0
Patients with post-cardiac surgery
Dose-dependent respiratory drive depression induced by current sedatives	DEX does not impair respiratory drive	17	0	0
Propofol and benzodiazepines show no analgesia properties	DEX may exert synergic analgesia effects	16	0	0
Gastrointestinal paralysis due to opioid use	DEX may reduce the occurrence of gastrointestinal paralysis due to opioid use	13	0	3
Patients with delirium
Risk of oversedation and difficulties in obtaining a light sedation level	DEX does not impair respiratory drive	17	0	0
	DEX improves the comfort and interaction with the environment	15	0	2
Use of benzodiazepines may increase the incidence of delirium	DEX reduces the occurrence of delirium and exerts protective effects on cognitive function	17	0	0
Practical use of antipsychotics and anxiolytics for agitation and delirium	DEX in combination with antipsychotics preserves cognitive function and reduces the occurrence of delirium	15	0	2
	DEX allows reduction of other antipsychotics	14	1	2

DEX: dexmedetomidine; NIV: non invasive ventilation