What factors influence your decision between dexmedetomidine and propofol for sedation in mechanically ventilated patients?

The main factor that influences this decision in my practice is the indication for mechanical ventilation. For patients in whom the main indication is airway protection, such that the patient would not otherwise require oxygenation or ventilation support, I aim for higher RASS goals (-1 to +1) and thus prefer dexmedetomidine. For patients who require light sedation or deep sedation with paralysis for respiratory failure or for whom ventilator dyssynchrony is leading to harm or adverse events (e....