The clinical value of dexmedetomidine during mechanical ventilation in icu patients of different ages
10.11855/j.issn.0577-7402.2015.09.15
- Author:
Yan ZHU
1
Author Information
1. Department of Emergency, Changzheng Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Artificial;
Deep sedation;
Dexmedetomidine;
Intensive care units;
Respiration
- From:
Medical Journal of Chinese People's Liberation Army
2015;40(9):758-762
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To provide basis for the safe use of indigenous dexmedetomidine hydrochloride by observing its sedative effect and safety when it was given to mechanically ventilated patients of different ages. MethodsThree hundred and fourteen mechanically ventilated patients were admitted to our ICU. According to the age, patients were divided into two subgroups: group A (25-50 years old) and group B (51-80 years old), with 157 patients in each group. Dexmedetomidine was given to achieve the target sedation level (Ramsay score 3). The changes in noninvasive blood pressure (SBP, DBP, MAP), heart rate, SpO2, respiratory rate and FiO2 were continuously monitored and recorded before treatment (T1), and 10min (T2), 30min (T3) and 120min (T4) after drug administration, on the instant moment of extubation (T5), and 30min after extubation (T6). The adverse reactions such as hypertension, hypotension, bradycardia, tachycardia, delirium were also observed and recorded after treatment. ResultsPatients of both A and B groups showed a lowering of SBP, DBP, MAP and HR after treatment with dexmedetomidine, especially in group B (P<0.05), though they were still maintained at an acceptable range (MAP>80mmHg, HR>60 times/min). Respiratory rate was reduced (P<0.05), without affecting FiO2 and PEEP (P>0.05). SpO2 was not reduced, and it even rose 30min after administration of dexmedetomidine (P<0.05). In addition, sedation was maintained in patients of both C and D groups during extubation, and their blood pressure, SpO2, respiratory rate were maintained stable before and after extubation (P>0.05), and the heart rate was slightly slower in group B (P<0.05). The probability of occurrence of adverse reactions, such as hypertension, hypotension, tachycardia, bradycardia and delirium was significantly higher in group B than in group A. ConclusionsDexmedetomidine does not depress respiration, and a stable hemodynamics was maintained after extubation in ICU patients undergoing mechanical ventilation, thus it is an ideal sedative drug. But when it is used in elderly patients, proper monitoring should be maintained, especially when a loading dose is used, in order to prevent adverse reactions such as hypotension and bradycardia, and should be corrected in time.
