Delirium prevention: another piece of the puzzle

In an electronic publication released before print from The Lancet on August 16, 2016, Su et al. (1) presented the results of a randomized, double-blind, placebo-controlled trial in which a dexmedetomidine infusion markedly decreased the incidence of delirium in elderly patients admitted to the intensive care unit (ICU) after non-cardiac surgery. The data are compelling and novel, in that the dexmedetomidine infusion consisted of a low, sub-sedative dose. This two-center study, which included 700 patients, was well-powered to demonstrate the clinical effectiveness of a prophylactic dexmedetomidine infusion to reduce delirium.