右美托咪定、咪达唑仑、丙泊酚长时间时间机械通气镇静的比较研究

of ICU stay with an expected ICU stay of C48 h and sedation need for C24 h after randomization. Patients were assigned to either DEX (B1.4 lg kg-1 h-1; n = 41) or SC (n = 44), with daily sedation stops.Results: Non-inferiority of DEX versus SC was not confirmed. Target Richmond agitation–sedation score (RASS) was reached a median of 64% (DEX) and 63% (SC) of the sedation time (ns). The length of ICU stay was similar in DEX and SC. Patients with RASS target 0–3 (DEX 78%, SC 80%) were at target sedation 74% (DEX) and 64% (SC) of the time (ns), whereas those with RASS target -4 or less reached the target 42% (DEX) and 62% (SC) of the time (P = .006). Post hoc analyses suggested shorter duration of mechanical ventilation for DEX (P = 0.025).Conclusions: This pilot study suggests that in long-term sedation, DEX is comparable to SC in maintaining sedation targets of RASS 0 to -3 but not suitable for deep sedation (RASS -4 or less). DEX had no effect on length of ICU stay. Its effects on other relevant clinical outcomes, such as duration of mechanical ventilation,should be tested further.

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