Prehospital emergency medical service missions to nursing homes - a descriptive retrospective register-based study in Southwest Finland.

Each year, over 2 million patients undergo cardiac surgery worldwide, facing significant risks associated with invasive procedures []. These surgeries often lead to systemic inflammation and a high incidence of postoperative complications []. Among these, postoperative pulmonary complications (PPCs)—ranging from mild hypoxemia to severe acute respiratory distress syndrome (ARDS)—are particularly prevalent [, ]. PPCs are a major cause of morbidity and mortality in this patient population, resulting in longer hospital stays, increased healthcare costs, and higher mortality rates [–]. These factors underscore the critical importance of addressing PPCs in cardiac surgical care. Dexmedetomidine, a selective α2 receptor agonist, is commonly used as an adjunct in the operating room for its sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, with minimal respiratory depression []. During cardiac surgeries, dexmedetomidine has been proven to be beneficial for reducing postoperative delirium, preventing acute kidney injury and reducing the duration of intensive care and tracheal intubation while maintaining relatively stable hemodynamics [, –]. Recent studies have shown that dexmedetomidine administration during thoracic surgery and cardiac surgery [] may reduce the risk of PPCs [] and improve oxygenation and lung compliance []. This is likely associated with the anti-inflammatory effects [, ] and improvements in lung mechanics [] caused by dexmedetomidine. Although adequate perioperative preparation and smooth surgical procedures can reduce the incidence of PPCs [], there remains a critical need for more effective and safer perioperative medications to further minimize these adverse outcomes. Dexmedetomidine has emerged in recent studies as one of the most promising pharmacologic strategies for improving patient-centered outcomes during surgery [, ]. However, the majority of this research has concentrated on its pain management and opioid-sparing effects, often neglecting its impact on respiratory function. Despite growing evidence supporting the physiological benefits of dexmedetomidine, a comprehensive pooled analysis specifically evaluating its effects on PPCs in cardiac surgery patients is still lacking.