The effect of dexmedetomidine on agitation during weaning of mechanical ventilation in critically ill patients 2010
作者：管理员 来源： 日期：2015/12/9 22:36:59 人气：
Summary Ventilated patients receiving opioids and/or benzodiazepines are at high risk of developing agitation, particularly upon weaning towards extubation. This is often associated with an increased intubation time and length of stay in the intensive care unit and may cause long-term morbidity. Anxiety, fear and agitation are amongst the most common non-pulmonary causes of failure to liberate from mechanical ventilation. This prospective, open-label observational study examined 28 ventilated adult patients in the intensive care unit (30 episodes) requiring opioids and/or sedatives for >24 hours, who developed agitation and/or delirium upon weaning from sedation and failed to achieve successful extubation with conventional management. Patients were ventilated for a median (interquartile range) of 115 [87 to 263] hours prior to enrolment. Dexmedetomidine infusion was commenced at 0.4 μg/kg/hour for two hours, after which concurrent sedative therapy was preferentially weaned and titrated to obtain target Motor Activity Assessment Score score of 2 to 4. The median (range) maximum dose and infusion time of dexmedetomidine was 0.7 μg/kg/hour (0.4 to 1.0) and 62 hours (24 to 252) respectively. The number of episodes at target Motor Activity Assessment Score score at zero, six and 12 hours after commencement of dexmedetomidine were 7/30 (23.3%), 28/30 (93.3%) and 26/30 (86.7%), respectively (P <0.001 for 6 and 12 vs 0 hours). Excluding unrelated clinical deterioration, 22 episodes (73.3%) achieved successful weaning from ventilation with a median (interquartile range) ventilation time of 70 (28 to 96) hours after dexmedetomidine infusion. Dexmedetomidine achieved rapid resolution of agitation and facilitated ventilatory weaning after failure of conventional therapy. Its role as first-line therapy in ventilated, agitated patients warrants further investigation.Key Words: dexmedetomidine, agitation, ventilation weaning, sedation, critical care PDF全文 |
本文网址：
已有条评论信息，点击查看网友评论
关于我们 | 联系信息 | 法律声明 | 意见反馈 | 在线投稿 | RSS订阅 | 
| 网络举报
Copyright 2008-2013 四川智康科技有限责任公司 All Rights Reserved.
备案号：蜀ICP备13020940号
建议使用IE浏览器达到最佳浏览效果
| 网络举报Copyright 2008-2013 四川智康科技有限责任公司 All Rights Reserved.
备案号：蜀ICP备13020940号
建议使用IE浏览器达到最佳浏览效果