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Results   Of the 74 randomized patients (median age, 57 years; 18 [24%] women), 2 withdrew consent later and 1 was found to have been randomized incorrectly, leaving 39 patients in the dexmedetomidine group and 32 patients in the placebo group for analysis. Dexmedetomidine increased ventilator-free hours at 7 days compared with placebo (median, hours vs hours, respectively; median difference between groups, hours [95% CI, to hours]; P  = .01). Among the 21 a priori secondary outcomes, none were significantly worse with dexmedetomidine, and several showed statistically significant benefit, including reduced time to extubation (median, hours vs hours with placebo; median difference between groups, hours [95% CI, to hours]; P  < .001) and accelerated resolution of delirium (median, hours vs hours; median difference between groups, hours [95% CI, to hours]; P  = .01). Using hierarchical Cox modeling to adjust for imbalanced baseline characteristics, allocation to dexmedetomidine was significantly associated with earlier extubation (hazard ratio, [95% CI, -]; P  = .007).





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