Effects of sedation with propofol versus dexmedetomidine on outcomes in mechanically ventilated patients with severe pulmonary infection: based on Medical Information Mart for Intensive Care Ⅳ database
10.3760/cma.j.cn131073-20241226-00513
- VernacularTitle:丙泊酚与右美托咪定镇静对重症肺部感染机械通气患者预后影响的比较：基于MIMIC-Ⅳ数据库
- Author:
Wenyuan ZHANG
1
;
Ping CUI
;
Yan WANG
;
Hui YE
;
Kai ZHANG
;
Weijue LI
;
Baoli CHENG
;
Xiangming FANG
Author Information
1. 浙江大学医学院附属儿童医院国家儿童健康与疾病临床医学研究中心，杭州 310052
- Publication Type:Journal Article
- Keywords:
Propofol;
Dexmedetomidine;
Conscious sedation;
Prognosis;
Respiration, artificial;
Pulmonary infection
- From:
Chinese Journal of Anesthesiology
2025;45(5):592-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of propofol and dexmedetomidine for sedation on the outcome in mechanically ventilated patients with severe pulmonary infection.Methods:Patients with severe pulmonary infection (Clinical Pulmonary Infection Score >7) requiring mechanical ventilation from the Medical Information Mart for Intensive Care Ⅳ database between 2008 and 2020 were selected and divided into propofol group and dexmedetomidine group based on the sedative agent used. The primary outcome was all-cause in-hospital mortality, and secondary outcomes included 90-day all-cause mortality and duration of mechanical ventilation. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline confounders, and logistic regression and linear regression were applied to analyze the effects of the two sedative drugs on the outcomes of mechanically ventilated patients with pulmonary infection. Kaplan-Meier survival curves were used to analyze survival outcomes.Results:A total of 6 204 critically ill patients with pulmonary infection requiring mechanical ventilation were included, with 3 439 cases in propofol group and 2 765 cases in dexmedetomidine group. The baseline characteristics between the two groups were well balanced (standardized mean difference < 0.1) after IPTW adjustment. In the IPTW-adjusted cohort, the in-hospital all-cause mortality and 90-day all-cause mortality were significantly lower in dexmedetomidine group than in propofol group (439.2[18.7%] vs 563.6[24.1%], 618.0[26.3%] vs 733.6[31.3%], P<0.001), the results of Further Kaplan-Meier survival curve analysis showed that the 90-day all-cause mortality was significantly lower in dexmedetomidine group than in propofol group ( P<0.01). Conclusions:Compared with propofol, dexmedetomidine can decrease the mortality rate and improve the prognosis in mechanically ventilated patients with severe pulmonary infection when used for sedation.
