Camarena AG, Zinker EE, Poblano MM, Aguirre SJ, Martínez SJ

Language: Spanish
References: 12
Page: 10-14
PDF size: 68.86 Kb.

ABSTRACT

Introduction: Dexmedetomidine is used for sedation in the intensive care unit (ICU). The effects of the infusion of this drug for more than 24 hours are not enough known.
Objective: To evaluate the efficacy and safety of dexme-detomidine infusion in ICU patients for more than 24 hours.
Design: Retrospective study.
Setting: ICU of a tertiary care hospital, Mexico City.
Methods: We carried out a retrospective study from 13th May 2003 to 7th May 2004 in 39 adults patients. Statistical tests were made with variance analysis.
Interventions: None.
Results: On the first hour of treatment heart rate and mean arterial pressure changed (p ‹ 0.05). The basal mean arterial pressure was 88 mmHg ± 13, 75 ± 10.1, 75 ± 10.6, 72 ± 7.4 at 24, 48 y 72 hours, respectively. The basal heart rate was 93.7 ± 20.7, 79 ± 14.8, 77.5 ± 13.7 and 76.92 ± 10 beats/min, respectively at the same period of time.
Conclusions: Dexmedetomidine infusion is safe when it is used for more than 24 hours in critically ill patients.

REFERENCES

1. Task Force of the American College of Critical Care Medicine of the Society of Critical Care Medicine, in collaboration with the American Society of Health-Systems Pharmacists (ASHP), in alliance with the American College of Chest Physicians: Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002;30:119-136.

2. Ostermann ME, Keenan SP, Seiferling RA et al. Sedation in the intensive care unit: a systematic review. JAMA 2000;283:1451-1459.

3. Kollef MH, Levy NT, Ahrens TS et al. The use of continuous IV sedation is associated with prolongation of mechanical ventilation. Chest 1998;114:541-554.

4. Kamibayashi T, Maze M. Clinical uses of alpha2- adrenergic agonists. Anesthesiology 2000;93:1345-1350.

5. 5, Coursin DB, Coursin DB, Maccioli GA. Dexmedetomidine. Current Opinion in Critical Care 2001;7:221-226.

6. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 2000;93:382-94.

7. Venn RM, Bradshaw CJ, Spencer R et al. Preliminary UK experience of dexmedetomidine, a novel agent for postoperative in the intensive care unit. Anesthesia 1999;54: 1136-1142.

8. Brede M, Wiesmann F, Jahns R, Hadamek K, Arnolt C, Neubauer S, Lohse MJ, Hein L. Feedback inhibition of catecholamine release by two different alpha2-adrenoceptor subtypes prevents progression of heart failure. Circulation 2002;106:2491-6.

9. Multz AS. Prolonged dexmedetomidine infusion as an adjunct in treating sedation-induced withdrawal. Anesth Anal 2003;96:1054-5.

10. Venn RM, Newman PJ, Grounds RM. A phase II study to evaluate the efficacy of dexmedetomidine for sedation in the medical intensive care unit. Intensive Care Med 2003;29:201-207.

11. De Wolf AM, Fragen RJ, Avram MJ et al. The pharmacokinetics of dexmedetomidine in volunteers with severe renal impairment. Anesth Analg 2001;93:1205-9.

12. Shehabi Y, Ruettimann U, Adamson H, Innes R, Ickeringill M. Dexmedetomidine infusion for more than 24 hours in critically ill patients: sedative and cardiovascular effects. Intensive Care Med 2004;30:2188-96.