Clinical study of midazolam sequential with dexmedetomidine for agitated patients undergoing weaning to implement light sedation in intensive care unit
| Autor: | Lei Xu, Jie Zhang, Xin-Jing Gao, Zhi-bo Li, Xing Lu, Tong Li, Jun Li |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Care medicine.drug_class Sedation medicine.medical_treatment Midazolam Loading dose Risk Assessment Statistics Nonparametric law.invention 03 medical and health sciences 0302 clinical medicine Mechanical ventilation 030202 anesthesiology law Heart rate medicine Humans Hypnotics and Sedatives Orthopedics and Sports Medicine Prospective Studies Dexmedetomidine Light sedation Aged business.industry Delirium 030208 emergency & critical care medicine Length of Stay Middle Aged Prognosis Intensive care unit Respiration Artificial Surgery Intensive Care Units Treatment Outcome Anesthesia Sedative Original Article Female medicine.symptom business Ventilator Weaning medicine.drug |
| Zdroj: | Chinese Journal of Traumatology |
| ISSN: | 1008-1275 |
| DOI: | 10.1016/j.cjtee.2015.09.007 |
| Popis: | Purpose To evaluate midazolam sequential with dexmedetomidine for agitated patients undergoing weaning to implement light sedation in ICU. Methods This randomized, prospective study was conducted in Tianjin Third Central Hospital, China. Using a sealed-envelope method, the patients were randomly divided into 2 groups (40 patients per group). Each patient of group A received an initial loading dose of midazolam at 0.3–3 mg/kg·h 24 h before extubation, followed by an infusion of dexmedetomidine at a rate of 0.2–1 μg/kg·h until extubation. Each patient of group B received midazolam at a dose of 0.3–3 mg/kg·h until extubation. The dose of sedation was regulated according to RASS sedative scores maintaining in the range of -2-1. All patients were continuously monitored for 60 min after extubation. During the course, heart rate (HR), mean artery pressure (MAP), extubation time, adverse reactions, ICU stay, and hospital stay were observed and recorded continuously at the following time points: 24 h before extubation (T1), 12 h before extubation (T2), extubation (T3), 30 min after extubation (T4), 60 min after extubation (T5). Results Both groups reached the goal of sedation needed for ICU patients. Dexmedetomidine was associated with a significant increase in extubation quality compared with midazolam, reflected in the prevalence of delirium after extubation (20% (8/40) vs 45% (18/40)), respectively (p = 0.017). There were no clinically significant decreases in HR and MAP after infusing dexmedetomidine or midazolam. In the group A, HR was not significantly increased after extubation; however, in the group B, HR was significantly increased compared with the preextubation values (p |
| Databáze: | OpenAIRE |
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