Open Access

Correction: Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS randomized controlled trial

  • Pratik P Pandharipande1, 2,
  • Robert D Sanders3Email author,
  • Timothy D Girard4, 5, 6,
  • Stuart McGrane1, 2,
  • Jennifer L Thompson7,
  • Ayumi K Shintani7,
  • Daniel L Herr8,
  • Mervyn Maze9,
  • E Wesley Ely4, 5, 6 and
  • the MENDS investigators
Critical Care201115:402

https://doi.org/10.1186/cc9416

Published: 14 January 2011

After publication of our article [1], we noted typographical errors in our tables and in the labelling of Figure 3 (Figure 1). There have been no changes to the results or their interpretation.
Figure 1

Kaplan-Meier curve showing probability of survival during the first 28 days according to treatment group, among patients with sepsis. Dexmedetomidine decreased the probability of dying within 28 days by 70%; this beneficial effect was not seen in patients who were not septic (P value for interaction = 0.11 implying an interaction between sepsis and the treatment groups).

In Table 1, 2 and 3 the number of dexmedetomidine patients without sepsis should read 21 instead of the published 20. The numbers in the corresponding text are correct. The corrected tables can be found overleaf.
Table 1

Baseline characteristics of patients with and without sepsis*

 

Patients with sepsis

Patients without sepsis

Variable

DEX (n = 31)

LZ (n = 32)

DEX (n = 21)

LZ (n = 19)

Age

60 (46, 65)

58 (44, 66)

61 (50, 68)

60 (52, 67)

Males

58%

41%

57%

53%

APACHE II

30 (26, 34)

29 (24, 32)

27 (20, 31)

25 (20, 30)

SOFA score

10 (9,13)

9 (8, 12)

9 (8, 12)

8 (7, 9)

IQCODE at enrollment

3 (3, 3)

3 (3, 3)

3 (3, 3)

3 (3, 3)

Medical ICU

77%

81%

62%

47%

Surgical ICU

23%

19%

38%

53%

Pre-enrollment lorazepam (mg)

1.5 (0, 5)

0 (0, 4)

0 (0, 4)

0 (0, 2)

Enrollment RASS

-3 (-4, -2)

-4 (-4, -3)

-3 (-4, 0)

-3 (-4, -1)

SIRS criteria

    

   Temperature (Fahrenheit)

37.5 (37, 38.3)

38 (37.2, 38.6)

36.7 (35.8, 37.8)

37.2 (36.2, 38.3)

   White blood count (103/μL)

12.5 (6.6, 21.7)

12.5 (7.7, 18.8)

14.6 (8.9,17.9)

10 (7.5,14)

   Systolic BP (mm Hg)

88 (78, 100)

83 (79, 100)

92 (90, 100)

90 (80,110)

   Heart rate (per minute)

113 (100, 134)

119 (96, 130)

80 (65,123)

107 (99, 126)

   Respiratory rate

26 (20, 33)

33 (27, 39)

20 (15, 24)

24 (20,28)

Organ dysfunction at enrollment

    

   PaO2/FiO2 ratio

128 (105, 209)

126 (94, 198)

127 (72, 211)

145 (81, 223)

   Creatinine (mg/dL)

1.7 (0.8, 2.9)

1.0 (0.8, 1.8)

1.2 (1.0, 1.7)

0.9 (0.8, 1.4)

   Vasopressors

32%

56%

19%

5%

   Bilirubin (mg/dL)

0.5 (0.4, 0.8)

0.9 (0.4, 1.8)

0.6 (0.5, 1.6)

0.6 (0.4, 1.1)

   Platelets (103/μL)

176 (61, 304)

183 (107, 266)

186 (101,242)

145 (114, 242)

Median (interquartile range) unless otherwise noted

*Abbreviations: DEX, dexmedetomidine; LZ, lorazepam; APACHE II, Acute Physiology and Chronic Health Evaluation II; SOFA, Sequential Organ Failure Assessment; IQCODE, Informant Questionnaire on Cognitive Decline in the Elderly; ICU, intensive care unit; SIRS, Systemic Inflammatory Response Syndrome; BP, Blood pressure.

Table 2

Outcomes of patients with and without sepsis*

 

Patients with sepsis

Patients without sepsis

Outcome variable

DEX (n = 31)

LZ (n = 32)

Adjusted

P value**

DEX (n = 21)

LZ (n = 19)

Adjusted

P value**

Duration of Brain Organ Dysfunction

      

   Delirium/coma-free days**

6.1 (4.3)

2.9 (3.2)

0.005

6 (4.7)

5.5 (3.6)

0.97

   Delirium-free days

8.1 (3.1)

6.7 (2.9)

0.06

8.1 (3.5)

7.9 (2.8)

0.80

   Coma-free days§

9.4 (2.9)

5.9 (4.2)

< 0.001

8.9 (4)

8.8 (2.6)

1

Other clinical outcomes

      

   MV-free days

15.2 (10.6)

10.1 (10.3)

0.03

12.8 (11.5)

17.2 (10)

0.15

   ICU days

13.4 (15.1)

12.2 (9.8)

0.81

14.9 (16.5)

10.4 (8.9)

0.28

   28-day mortality

16%

41%

0.03

19%

5%

0.21

Mean (standard deviation) unless otherwise noted

Abbreviations: DEX, dexmedetomidine; LZ, lorazepam; ICU, intensive care unit; MV, mechanical ventilation

*Adjusted P value obtained from the bootstrap multiple linear regression that calculated a difference in mean for each outcome between the two treatment groups, adjusting for age, severity of illness, use of drotrecogin alfa (activated) within 48 hours of enrollment, sepsis, treatment group, and a treatment group by sepsis interaction.

**Indicates the number of days alive without delirium or coma from study day 1 to 12.

Indicates the number of days alive without delirium from study day 1 to 12.

§Indicates the number of days alive without coma from study day 1 to 12.

Indicates the number of days alive breathing without assistance of the ventilator from study day 1 to 28.

Table 3

Hemodynamic parameters in patients with and without sepsis*

 

Patients with sepsis

Patients without sepsis

Hemodynamic variable**

DEX (n = 31)

LZ (n = 32)

P value

DEX (n = 21)

LZ (n = 19)

P value

Number of days on vasoactive drugs

1 (1)

2 (2)

0.08

1.5 (2.2)

0.3 (0.9)

0.08

Average daily number of vasoactive drugs

1.1 (0.2)

1.6 (0.5)

0.004

1.6 (0.9)

1 (0)

0.2

Ever vasoactive drugs increased

26%

47%

0.08

33%

16%

0.2

Sinus bradycardia (< 60 beats/min)

13%

6%

0.4

24%

0%

0.02

Sinus tachycardia (> 100 beats/min)

81%

84%

0.7

52%

53%

1

Mean (standard deviation) unless otherwise noted

*Abbreviations: DEX, dexmedetomidine; LZ, lorazepam

** Measured during 120-hour study drug protocol, except for sinus bradycardia & sinus tachycardia, which are measured during entire study.

In Figure 3 (Figure 1) in the "Patients at risk" table below the Kaplan-Meier curve, the dexmedetomidine and lorazepam labels are incorrect. The top row should be labeled lorazepam and the bottom row should be labeled dexmedetomidine. The corrected figure can be found overleaf.

Declarations

Authors’ Affiliations

(1)
Anesthesiology Service, VA TN Valley Health Care System
(2)
Department of Anesthesiology, Division of Critical Care, Vanderbilt University School of Medicine
(3)
Department of Leucocyte Biology & Magill Department of Anaesthetics, Intensive Care and Pain Medicine, Imperial College London, Chelsea & Westminster Hospital
(4)
Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine
(5)
Center for Health Services Research, Vanderbilt University School of Medicine
(6)
Veterans Affairs Tennessee Valley Geriatric Research, Education, and Clinical Center
(7)
Department of Biostatistics, Vanderbilt University School of Medicine
(8)
Department of Surgery and Surgical Critical Care, Washington Hospital Center
(9)
Department of Anesthesiology and Perioperative Care, University of California San Francisco

References

  1. Pandharipande PP, Sanders RD, Girard TD, McGrane S, Thompson JL, Shintani AK, Herr DL, Maze M, Ely EW, for the MENDS investigators: Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS randomized controlled trial. Crit Care. 2010, 14: R38-10.1186/cc8916.PubMedPubMed CentralView ArticleGoogle Scholar

Copyright

© BioMed Central Ltd 2011

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