Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial
Li Qiao, Zheng Wang, Jian Shen, Xiaohui Xing, Hongxun Yuan Department of Intensive Care Unit, Peking University International Hospital, Beijing, People’s Republic of ChinaCorrespondence: Hongxun Yuan, Department of Intensive Care Unit, Peking University International Hospital, No. 1 of Life Park Roa...
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| 格式: | Article |
| 語言: | English |
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Dove Medical Press
2024-09-01
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| 叢編: | Therapeutics and Clinical Risk Management |
| 主題: | |
| 在線閱讀: | https://www.dovepress.com/impact-of-dexmedetomidine-on-hemodynamics-plasma-catecholamine-levels--peer-reviewed-fulltext-article-TCRM |
| _version_ | 1827094773996978176 |
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| author | Qiao L Wang Z Shen J Xing X Yuan H |
| author_facet | Qiao L Wang Z Shen J Xing X Yuan H |
| author_sort | Qiao L |
| collection | DOAJ |
| description | Li Qiao, Zheng Wang, Jian Shen, Xiaohui Xing, Hongxun Yuan Department of Intensive Care Unit, Peking University International Hospital, Beijing, People’s Republic of ChinaCorrespondence: Hongxun Yuan, Department of Intensive Care Unit, Peking University International Hospital, No. 1 of Life Park Road, Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, People’s Republic of China, Tel +86 10 69006109, Email hongxunyuan_yhx@126.comObjective: To investigate the impact of various sedative medications on hemodynamics and plasma levels of epinephrine (E) and norepinephrine (NE) in mechanically ventilated patients postoperatively in the intensive care unit (ICU).Methods: Ninety-seven patients admitted to the ICU undergoing postoperative mechanical ventilation with tracheal intubation and continuous analgesic sedation following general anesthesia were randomly assigned to either the observation group (dexmedetomidine) (n = 49) or the control group (propofol) (n = 48) in this randomized controlled trial. Upon transfer to the ICU, vital signs (heart rate [HR], respiratory rate [RR], mean arterial pressure [MAP]) were recorded prior to the initiation of the sedation treatment (T0), at one-hour post sedation (T1) and two hours following tracheal extubation (T2), plasma levels of epinephrine (E) and norepinephrine (NE) were measured at these time points. The incidence of delirium was recorded in both groups.Results: MAP between the two groups at both T0 and T1 At T2 plasma NE and HR were found to be lower in the observation group compared to the control group (P < 0.001). Among the patients receiving antihypertensive medication in the ICU, NE levels were significantly lower in the observation group compared to the control group (P = 0.019) Among the patients not receiving antihypertensive medication, both NE (P < 0.001) and MAP (P = 0.001) levels were lower in the observation group compared to the control group. The incidence of delirium in the observation group (dexmedetomidine) was not significantly different from that in the control group (propofol).Conclusion: With dexmedetomidine sedation, blood pressure fluctuated less, plasma catecholamine levels were lower, and sympathetic inhibition was stronger in patients before and after extubation. However, it did not significantly reduce the incidence of postoperative delirium.Keywords: delirium, intensive care unit, hemodynamics, plasma norepinephrine, delirium |
| first_indexed | 2025-03-20T06:49:19Z |
| format | Article |
| id | doaj.art-7af34c2f05d84b98991c6e512b5110d3 |
| institution | Directory Open Access Journal |
| issn | 1178-203X |
| language | English |
| last_indexed | 2025-03-20T06:49:19Z |
| publishDate | 2024-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Therapeutics and Clinical Risk Management |
| spelling | doaj.art-7af34c2f05d84b98991c6e512b5110d32024-10-01T18:41:48ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2024-09-01Volume 2068970096042Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled TrialQiao LWang ZShen JXing XYuan HLi Qiao, Zheng Wang, Jian Shen, Xiaohui Xing, Hongxun Yuan Department of Intensive Care Unit, Peking University International Hospital, Beijing, People’s Republic of ChinaCorrespondence: Hongxun Yuan, Department of Intensive Care Unit, Peking University International Hospital, No. 1 of Life Park Road, Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, People’s Republic of China, Tel +86 10 69006109, Email hongxunyuan_yhx@126.comObjective: To investigate the impact of various sedative medications on hemodynamics and plasma levels of epinephrine (E) and norepinephrine (NE) in mechanically ventilated patients postoperatively in the intensive care unit (ICU).Methods: Ninety-seven patients admitted to the ICU undergoing postoperative mechanical ventilation with tracheal intubation and continuous analgesic sedation following general anesthesia were randomly assigned to either the observation group (dexmedetomidine) (n = 49) or the control group (propofol) (n = 48) in this randomized controlled trial. Upon transfer to the ICU, vital signs (heart rate [HR], respiratory rate [RR], mean arterial pressure [MAP]) were recorded prior to the initiation of the sedation treatment (T0), at one-hour post sedation (T1) and two hours following tracheal extubation (T2), plasma levels of epinephrine (E) and norepinephrine (NE) were measured at these time points. The incidence of delirium was recorded in both groups.Results: MAP between the two groups at both T0 and T1 At T2 plasma NE and HR were found to be lower in the observation group compared to the control group (P < 0.001). Among the patients receiving antihypertensive medication in the ICU, NE levels were significantly lower in the observation group compared to the control group (P = 0.019) Among the patients not receiving antihypertensive medication, both NE (P < 0.001) and MAP (P = 0.001) levels were lower in the observation group compared to the control group. The incidence of delirium in the observation group (dexmedetomidine) was not significantly different from that in the control group (propofol).Conclusion: With dexmedetomidine sedation, blood pressure fluctuated less, plasma catecholamine levels were lower, and sympathetic inhibition was stronger in patients before and after extubation. However, it did not significantly reduce the incidence of postoperative delirium.Keywords: delirium, intensive care unit, hemodynamics, plasma norepinephrine, deliriumhttps://www.dovepress.com/impact-of-dexmedetomidine-on-hemodynamics-plasma-catecholamine-levels--peer-reviewed-fulltext-article-TCRMdeliriumintensive care unithemodynamicsplasma norepinephrinedelirium |
| spellingShingle | Qiao L Wang Z Shen J Xing X Yuan H Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial Therapeutics and Clinical Risk Management delirium intensive care unit hemodynamics plasma norepinephrine delirium |
| title | Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial |
| title_full | Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial |
| title_fullStr | Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial |
| title_full_unstemmed | Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial |
| title_short | Impact of Dexmedetomidine on Hemodynamics, Plasma Catecholamine Levels, and Delirium Incidence Among Intubated Patients in the ICU--A Randomized Controlled Trial |
| title_sort | impact of dexmedetomidine on hemodynamics plasma catecholamine levels and delirium incidence among intubated patients in the icu a randomized controlled trial |
| topic | delirium intensive care unit hemodynamics plasma norepinephrine delirium |
| url | https://www.dovepress.com/impact-of-dexmedetomidine-on-hemodynamics-plasma-catecholamine-levels--peer-reviewed-fulltext-article-TCRM |
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