Evaluating the Effect of Dexmedetomidine on Hemodynamic Status of Patients with Septic Shock Admitted to Intensive Care Unit: A Single-Blind Randomized Controlled Trial.

Autor: Gheibi S; Department of Pharmacotherapy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran., Ala S; Department of Pharmacotherapy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran., Heydari F; Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran., Salehifar E; Pharmaceutical Science Research Center, Hemoglobinopathy institute, Sari, Iran., Abbaspour Kasgari H; Department of Clinical pharmacy, Antimicrobial Resistance Research Center, Ghaemshahr Razi hospital, Mazandaran University of Medical Science,sari,Iran., Moradi S; Directr of Medical Education Development Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Jazyk: angličtina
Zdroj: Iranian journal of pharmaceutical research : IJPR [Iran J Pharm Res] 2020 Fall; Vol. 19 (4), pp. 255-263.
DOI: 10.22037/ijpr.2019.112343.13699
Abstrakt: Septic shock, known as the most severe complication of sepsis, is a serious medical condition that can lead to death. Clinical symptoms of sepsis include changes in body temperature in the form of hypothermia or hyperthermia, tachypnea or hyperventilation, tachycardia, leukocytosis or leukopenia, and variations in blood pressure, as well as altered state of consciousness. One of the main problems in septic shock is poor response along with reduced vascular reactivity to vasopressors used to increase blood pressure. Therefore, low vascular response associated with reduced sensitivity or lower number of alpha-1 agonist receptors can result in shock and death. In addition to being the state-of-the-art treatment including volume load and vasopressor, use of alpha-2 agonists e.g . dexmedetomidine (DXM) in septic shock can reduce vasopressors needed to restore adequate blood pressure. They can further moderate massive release of endogenous catecholamine. Therefore, the purpose of this study was to investigate the effect of DXM on outcomes of patients with septic shock, especially their needs for vasopressors and impacts on their hemodynamic status. This single-blind randomized controlled trial was performed on a total number of 66 patients with septic shock admitted to the intensive care unit (ICU) of Imam Khomeini Teaching Hospital in the city of Sari, in northern Iran. To this end, DXM (0.6 µg/kg/h) and normal saline (6 mL/kg/h) were infused for 12 h in the study and control groups, respectively. The results revealed that DXM could increase mean arterial pressure (MAP) ( P = 0.021), systolic blood pressure (SBP) ( P = 0.002), and reduced heart rate ( P < 0.001) but diastolic blood pressure (DBP) ( P =0.32) and norepinephrine dose requirement didn't change statistically in septic shock patients ( P = 0.12).
Databáze: MEDLINE