Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated
Background Sepsis has been associated with microvascular alterations. Studies have shown dexmedetomidine to have a beneficial effect on the microcirculation in patients with sepsis. In search for better sedation modality, we compared between dexmedetomidine and midazolam in terms of tissue perfusion...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2109826 |
| _version_ | 1798039981786136576 |
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| author | Mostafa Mohamed Atef Refaat Laila Ali Elkafrawy Reem Hamdy Elkabarity Amr Fouad Hafez |
| author_facet | Mostafa Mohamed Atef Refaat Laila Ali Elkafrawy Reem Hamdy Elkabarity Amr Fouad Hafez |
| author_sort | Mostafa Mohamed Atef Refaat |
| collection | DOAJ |
| description | Background Sepsis has been associated with microvascular alterations. Studies have shown dexmedetomidine to have a beneficial effect on the microcirculation in patients with sepsis. In search for better sedation modality, we compared between dexmedetomidine and midazolam in terms of tissue perfusion in patients suffering from sepsis.Methods A total of 128 patients with sepsis requiring sedation and mechanical ventilation were randomized into 2 groups. Each group comprised 64 patients: Group A (sedated by dexmedetomidine) and Group B (sedated by midazolam); assessment of microcirculation during sedation infusion was performed directly through the peripheral perfusion index (PPI) and indirectly by using global markers of perfusion (ScvO2, P(v-a)Co2).Results Sixty-four patients were analyzed in each group. Base line characteristics were similar in both groups. We found no significant differences (p > 0.05) between microcirculatory parameters, PPI, Scvo2, and P(v-a)CO2 when comparing between both sedated groups. The 28-day mortality rate was significantly lower (p = 0.042) in dexmedetomidine patients (26.6%) as compared to midazolam patients (43.8%). In addition, there was no difference in ICU stay between the two groups (p = 0.061).Conclusion Using dexmedetomidine as a sedation option did not provide better peripheral perfusion in patients with sepsis. |
| first_indexed | 2024-04-11T22:01:12Z |
| format | Article |
| id | doaj.art-48e62712b31b4017846f97c1892eb1a2 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-11T22:01:12Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-48e62712b31b4017846f97c1892eb1a22022-12-22T04:00:55ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138145946510.1080/11101849.2022.2109826Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilatedMostafa Mohamed Atef Refaat0Laila Ali Elkafrawy1Reem Hamdy Elkabarity2Amr Fouad Hafez3Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, EgyptBackground Sepsis has been associated with microvascular alterations. Studies have shown dexmedetomidine to have a beneficial effect on the microcirculation in patients with sepsis. In search for better sedation modality, we compared between dexmedetomidine and midazolam in terms of tissue perfusion in patients suffering from sepsis.Methods A total of 128 patients with sepsis requiring sedation and mechanical ventilation were randomized into 2 groups. Each group comprised 64 patients: Group A (sedated by dexmedetomidine) and Group B (sedated by midazolam); assessment of microcirculation during sedation infusion was performed directly through the peripheral perfusion index (PPI) and indirectly by using global markers of perfusion (ScvO2, P(v-a)Co2).Results Sixty-four patients were analyzed in each group. Base line characteristics were similar in both groups. We found no significant differences (p > 0.05) between microcirculatory parameters, PPI, Scvo2, and P(v-a)CO2 when comparing between both sedated groups. The 28-day mortality rate was significantly lower (p = 0.042) in dexmedetomidine patients (26.6%) as compared to midazolam patients (43.8%). In addition, there was no difference in ICU stay between the two groups (p = 0.061).Conclusion Using dexmedetomidine as a sedation option did not provide better peripheral perfusion in patients with sepsis.https://www.tandfonline.com/doi/10.1080/11101849.2022.2109826Intensive care unit (ICU)microcirculationsedationsepsisperfusionMasimo |
| spellingShingle | Mostafa Mohamed Atef Refaat Laila Ali Elkafrawy Reem Hamdy Elkabarity Amr Fouad Hafez Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated Egyptian Journal of Anaesthesia Intensive care unit (ICU) microcirculation sedation sepsis perfusion Masimo |
| title | Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated |
| title_full | Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated |
| title_fullStr | Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated |
| title_full_unstemmed | Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated |
| title_short | Effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated |
| title_sort | effect of dexmedetomidine vs midazolam on the microcirculation of septic patients who are mechanically ventilated |
| topic | Intensive care unit (ICU) microcirculation sedation sepsis perfusion Masimo |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2109826 |
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