Adrenergic

Sympathetic nervous system

Context (archaeology)

Intensive care medicine

Biology

Sepsis

Clonidine

Receptor

Anesthesia

Paleontology

Sedation

Bioinformatics

Blood pressure

Cardiopulmonary bypass

Internal medicine

Delirium

Dexmedetomidine

Medicine

Organ dysfunction

Septic shock

British Journal of Pharmacology

Agonists of α 2 ‐adrenoceptors are increasingly being used for the provision of comfort, sedation and the management of delirium in critically ill patients, with and without sepsis. In this context, increased sympathetic and inflammatory activity are common pathophysiological features linked to multi‐organ dysfunction, particularly in patients with sepsis or those undergoing cardiac surgery requiring cardiopulmonary bypass. Experimental and clinical studies support the notion that the α 2 ‐adrenoceptor agonists, dexmedetomidine and clonidine, mitigate sympathetic and inflammatory overactivity in sepsis and cardiac surgery requiring cardiopulmonary bypass. These effects can protect vital organs, including the cardiovascular system, kidneys, heart and brain. We review the pharmacodynamic mechanisms by which α 2 ‐adrenoceptor agonists might mitigate multi‐organ dysfunction arising from pathophysiological conditions associated with excessive inflammatory and adrenergic stress in experimental studies. We also outline recent clinical trials that have examined the use of dexmedetomidine in critically ill patients with and without sepsis and in patients undergoing cardiac surgery.

Emerging benefits and drawbacks of α<sub>2</sub>‐adrenoceptor agonists in the management of sepsis and critical illness

Emerging benefits and drawbacks of α2‐adrenoceptor agonists in the management of sepsis and critical illness

Emerging benefits and drawbacks of α₂‐adrenoceptor agonists in the management of sepsis and critical illness