Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
Abstract Background Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present st...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-020-1065-6 |
| _version_ | 1818990360294064128 |
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| author | Peifen Chen Jihong Jiang Yunhe Zhang Guobao Li Zhihui Qiu Mitchell M. Levy Baoji Hu |
| author_facet | Peifen Chen Jihong Jiang Yunhe Zhang Guobao Li Zhihui Qiu Mitchell M. Levy Baoji Hu |
| author_sort | Peifen Chen |
| collection | DOAJ |
| description | Abstract Background Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients. Methods Databases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0. Results Four studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, − 0.13 to 1.42, P = 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89, P = 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94, P = 0.02) in the septic patients. Conclusion Administration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality. |
| first_indexed | 2024-12-20T19:53:08Z |
| format | Article |
| id | doaj.art-a4e6ef58b0b94cf98835900f9a1f65a1 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-20T19:53:08Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-a4e6ef58b0b94cf98835900f9a1f65a12022-12-21T19:28:14ZengBMCBMC Pulmonary Medicine1471-24662020-02-0120111010.1186/s12890-020-1065-6Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysisPeifen Chen0Jihong Jiang1Yunhe Zhang2Guobao Li3Zhihui Qiu4Mitchell M. Levy5Baoji Hu6Department of Respiratory Diseases, The Third People’s Hospital of Shenzhen, the Second Affiliated Hospital of Southern University of Science and TechnologyDepartment of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Centre ICU, Shanghai East Hospital, School of Medicine, Tongji UniversityThe Third Department of Pulmonary Medicine, The Third People’s Hospital of Shenzhen, the Second Affiliated Hospital of Southern University of Science and TechnologyGastroscopy Room, The Third People’s Hospital of Shenzhen, the Second Affiliated Hospital of Southern University of Science and TechnologyDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Alpert Medical School at Brown UniversityDepartment of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients. Methods Databases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0. Results Four studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, − 0.13 to 1.42, P = 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89, P = 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94, P = 0.02) in the septic patients. Conclusion Administration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality.http://link.springer.com/article/10.1186/s12890-020-1065-6SepsisDuration of mechanical ventilationDexmedetomidineSystematic review and meta-analysis |
| spellingShingle | Peifen Chen Jihong Jiang Yunhe Zhang Guobao Li Zhihui Qiu Mitchell M. Levy Baoji Hu Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis BMC Pulmonary Medicine Sepsis Duration of mechanical ventilation Dexmedetomidine Systematic review and meta-analysis |
| title | Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis |
| title_full | Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis |
| title_fullStr | Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis |
| title_full_unstemmed | Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis |
| title_short | Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis |
| title_sort | effect of dexmedetomidine on duration of mechanical ventilation in septic patients a systematic review and meta analysis |
| topic | Sepsis Duration of mechanical ventilation Dexmedetomidine Systematic review and meta-analysis |
| url | http://link.springer.com/article/10.1186/s12890-020-1065-6 |
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