Yue Zhao1,2, Huaqiang Zhou3, Wulin Tan1, Yiyan Song3, Zeting Qiu1,3, Si Li3, Shaowei Gao1, Wenqi Huang1. 1. Department of Anesthesia, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China. 2. Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou 510317, China. 3. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.
Abstract
BACKGROUND: There is no conclusive evidence for the effects of prolonged infusion of dexmedetomidine in critically ill patients. We aimed to investigate the safety of long-term dexmedetomidine infusion in a large critically ill patients cohort from the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database. METHODS: We retrospectively extracted records from MIMIC-III database. Dexmedetomidine administration time was the basis for group. Variables were compared by chi-square tests, and Mann-Whitney U test as appropriate. We used logistic regression model for multivariate analysis. Contour maps were drawn to measure rebound of heart rate (HR) and blood pressure (BP). RESULTS: We finally got 1,946 records including 1,368 distinct individuals. Age, body mass index (BMI), length of stay in hospital, accumulated doses of dexmedetomidine and Sequential Organ Failure Assessment (SOFA) score were independent risk factors of in-hospital mortality (P<0.05). But prolonged dexmedetomidine infusion (≥24 h) and abrupt cessation did not increase in-hospital mortality. Furthermore, the rebound of HR and BP was more likely to occur in patients with prolonged infusion of dexmedetomidine. CONCLUSIONS: Prolonged dexmedetomidine infusion is not related to an increased in-hospital mortality, but it is associated with the rebound effect of HR and BP. Further prospective studies are needed.
BACKGROUND: There is no conclusive evidence for the effects of prolonged infusion of dexmedetomidine in critically ill patients. We aimed to investigate the safety of long-term dexmedetomidine infusion in a large critically ill patients cohort from the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database. METHODS: We retrospectively extracted records from MIMIC-III database. Dexmedetomidine administration time was the basis for group. Variables were compared by chi-square tests, and Mann-Whitney U test as appropriate. We used logistic regression model for multivariate analysis. Contour maps were drawn to measure rebound of heart rate (HR) and blood pressure (BP). RESULTS: We finally got 1,946 records including 1,368 distinct individuals. Age, body mass index (BMI), length of stay in hospital, accumulated doses of dexmedetomidine and Sequential Organ Failure Assessment (SOFA) score were independent risk factors of in-hospital mortality (P<0.05). But prolonged dexmedetomidine infusion (≥24 h) and abrupt cessation did not increase in-hospital mortality. Furthermore, the rebound of HR and BP was more likely to occur in patients with prolonged infusion of dexmedetomidine. CONCLUSIONS: Prolonged dexmedetomidine infusion is not related to an increased in-hospital mortality, but it is associated with the rebound effect of HR and BP. Further prospective studies are needed.
Entities:
Keywords:
Dexmedetomidine; Multiparameter Intelligent Monitoring in Intensive Care III database (MIMIC-III database); mortality; rebound effect
Authors: Pratik P Pandharipande; Brenda T Pun; Daniel L Herr; Mervyn Maze; Timothy D Girard; Russell R Miller; Ayumi K Shintani; Jennifer L Thompson; James C Jackson; Stephen A Deppen; Renee A Stiles; Robert S Dittus; Gordon R Bernard; E Wesley Ely Journal: JAMA Date: 2007-12-12 Impact factor: 56.272
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