BACKGROUND:Dexmedetomidine has the effect of anti-ischemia-reperfusion injury,but the comprehensive and systematic review of its signaling pathway is less. OBJECTIVE:To focus on the review of dexmedetomidine's signaling pathway in the mechanisms of antioxidant stress,inhibition of inflammation,anti-apoptosis,autophagy,and so on. METHODS:The relevant articles on PubMed,CNKI,WanFang,and VIP databases were searched by computer with the key words"ischemia-reperfusion inquiry;dexmedetomidine;signal path;oxidative stress;inflammation;apoptosis"in Chinese and English.After excluding repetitive research and some basic articles with low correlation,57 articles were finally included for review. RESULTS AND CONCLUSION:(1)Dexmedetomidine plays an important role in organ protection through many mechanisms,such as anti-oxidative stress injury,anti-inflammation,anti-apoptosis and autophagy.This involves many pathways,including Nrf2 and its downstream protein antioxidant stress pathway,Toll-like receptor 4 family and nuclear factor-κB-related anti-inflammatory pathway,JAK2/STAT3-related anti-inflammatory pathway,and cholinergic anti-inflammatory pathway,and the cholinergic pathway is the upstream mechanism of many nuclear factor-κB signaling pathways.(2)PI3K/Akt pathway plays different roles according to its activated downstream signals,inhibiting the activation of NLRP3 inflammatory body,activating signal molecules endothelial nitric oxide synthase,mammalian target of rapamycin,and hypoxia-inducible factor 1α to play an anti-inflammatory role,and activate Bad or Bax residues to play an anti-apoptotic role,and PI3K/Akt activates glycogen synthetase kinase-3β.It can also play an anti-inflammatory and anti-apoptotic role.(3)Dexmedetomidine activates SIRT3 to mediate anti-apoptosis and inhibit endoplasmic reticulum stress to produce anti-apoptosis.(4)The detailed review of the anti-ischemia-reperfusion injury signaling pathway of dexmedetomidine can provide a basis for future mechanism research and diagnosis and treatment decisions.

Acute respiratory distress syndrome (ARDS) is a leading cause of high mortality in critically ill patients in intensive care units (ICU). Prone ventilation is one of the important treatment methods for ARDS, but due to the severity of the patients' conditions, their physical weakness, and poor cooperation, it is difficult for them to adjust to the prone position on their own. This requires a large number of medical staff to adjust the patient to a prone position and implement prone ventilation for than 12 hours daily to achieve therapeutic effects. Clinical implementation often faces challenges such as a shortage of staff, patient discomfort, difficulty in changing positions prolonged time leading to bedsores, and lack of auxiliary equipment. It is particularly challenging for ARDS patients, especially those in critical condition, to adjust their on their own. Therefore, healthcare workers from the department of emergency of Yingtan 184 Hospital designed a prone and side lying double-purpose inflatable mattress for ARDS, and obtained the National Utility Model Patent of China (patent number: ZL 2023 2 1249425.7). The prone and side lying dual-purpose inflatable mattress mainly consists of a main mattress, a forehead pad, a prone position pad, and bilateral side lying position pads. The prone position pad and the lateral position pad on both sides are relatively independent, and can be inflated separately through their inflation nozzles to meet the ventilation needs of ARDS patients in prone or lateral positions, making it easy to adjust the patient's position. This mattress is reasonably designed, simple in structure, easy to operate, comfortable, and practical. It has transformation, promotion, and application value.