Overview

This is a pragmatic phase III, randomized, blinded, double placebo-controlled, three-arm trial of elderly patients following cardiac surgery to assess the relationship between nighttime intravenous (IV) and sublingual dexmedetomidine on postoperative delirium and functional outcomes after surgery.

Eligibility

Inclusion Criteria:

• Aged 60 years or older
• Scheduled to undergo a cardiac surgical procedure with cardiopulmonary bypass
• Planned postoperative admission to the intensive care unit (ICU)

Exclusion Criteria:

• Allergy or hypersensitivity to dexmedetomidine or the placebo study medication
• Preexisting diagnosis of Alzheimer's Disease or Related Dementia, severe cognitive impairment or delirium at baseline
• Severe liver failure (Child-Pugh score > 5)
• History of obstructive sleep apnea
• Severe deficit(s) due to structural or anoxic brain damage
• Undergoing a surgical procedure requiring total circulatory arrest
• SARS-CoV-2 positive or symptomatic (e.g., fever, cough, loss of taste/smell)
• Blind, deaf, or unable to communicate in English
• Patients experiencing circumstances for which long-term follow-up might be difficult (e.g., homelessness, active psychotic disorder, or substance abuse)
• Co-enrollment in other interventional studies that, in the opinion of the site investigator and/or PI, might interfere with study participation, collection, or interpretation of the study data