کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2741891 1148568 2016 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Efficacy and safety of sedation with dexmedetomidine in critical care patients: A meta-analysis of randomized controlled trials
ترجمه فارسی عنوان
اثربخشی و ایمنی آرامبخشی با دگزمودومیدین در بیماران مراقبت های حیاتی: یک متاآنالیز آزمایشهای کنترل شده تصادفی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

IntroductionDexmedetomidine may help physicians target a low level of sedation. Unfortunately, the impact of dexmedetomidine on major endpoints remains unclear in intensive care unit (ICU).Material and methodsTo evaluate the association between dexmedetomidine use with efficacy and safety outcomes, two reviewers independently identified randomized controlled trials comparing dexmedetomidine with other sedative agents in non-post-cardiac surgery critically ill patients in the PubMed and Cochrane databases. Random effects models were considered if heterogeneity was detected using the DerSimonian and Laird estimation method. Statistical heterogeneity between results was assessed by examining forest plots, confidence intervals (CI) and by using the I2 statistic. The risk of bias was assessed using the risk of bias tool.ResultsThis meta-analysis included 1994 patients from 16 randomized controlled trials. Comparators were lorazepam, midazolam and propofol. Dexmedetomidine was associated with a reduction in ICU length of stays (WMD = −0.304; 95% CI [−0.477, −0.132]; P = 0.001), mechanical ventilation duration (WMD = −0.313, 95% CI [−0.523, −0.104]; P = 0.003) and delirium incidence (RR = 0.812, 95% CI [0.680, 0.968]; P = 0.020). Dexmedetomidine is also associated with an increase in the incidence of bradycardia (RR = 1.947, 95% CI [1.387, 2.733]; P = 0.001) and hypotension (RR = 1.264; 95% CI [1.013, 1.576]; P = 0.038).Conclusions and relevanceIn this first meta-analysis including only randomized controlled trials related to ICU patients, dexmedetomidine was associated with a 48 h reduction in ICU length of stay, mechanical ventilation duration and delirium occurrence despite a significant heterogeneity among studies. Dexmedetomidine was also associated with an increase in bradycardia and hypotension.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Anaesthesia Critical Care & Pain Medicine - Volume 35, Issue 1, February 2016, Pages 7–15
نویسندگان
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