The Pharmacological Class Alpha 2 Agonists for Stress Control in Patients with Respiratory Failure: The Main Actor in the Different Acts

The role of sedation in patients with acute respiratory failure in the intensive care unit is crucial for improving the adaptation to mechanical ventilation, avoiding lung injury, and reducing stress related to the over-stimulated sympathetic tone. The drug class alpha 2 agonists, alone or in synergic association, can help the clinician achieve these goals. Understanding the principles of pharmacology and applying them to the alpha 2 agonists, clonidine and dexmedetomidine, can lead to different pharmaceutical choices to adapt various sedative approaches to the different stages of acute respiratory failure. A scheme is proposed using these two drugs as a pharmacological continuation for an early weaning and recovery from the intensive care unit.