Dexmedetomidine For The Treatment Of Acute Lung Injury: A Fact Or Fiction?

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
Zhongheng Zhang

Abstract

Dexmedetomidine has been widely used in the intensive care unit (ICU), with the primary aim to keep patients on an appropriate level of sedation. Both observational and randomized controlled trials have observed that the use of dexmedetomidine is associated with improved outcomes for mechanically ventilated patients [1]. In ICU patients receiving prolonged mechanical ventilation, dexmedetomidine was not inferior to other sedatives in maintaining sedation level, but was associated with shortened MV duration and improved ability to communicate pain [2]. MV is an important factor for delirium and dexmedetomidine was found to be associated with lower risk of delirium [3, 4]. Prophylactic low-dose dexmedetomidine is able to reduce the occurrence of delirium during the first 7 days after surgery for patients aged over 65 years who are admitted to the ICU after surgery [4]. Thus, the beneficial effect of might be explained by the reduction of delirium in the treated group. In fact, delirium can be considered as a type of acute organ dysfunction mediated via inflammatory response. There has been evidence that inflammatory biomarkers such as C-reactive protein was positively correlated with the occurrence of delirium [5].

References

Feb 4, 2009·JAMA : the Journal of the American Medical Association·Richard R RikerUNKNOWN SEDCOM (Safety and Efficacy of Dexmedetomidine Compared With Midazolam) Study Group
Mar 23, 2012·JAMA : the Journal of the American Medical Association·Stephan M JakobUNKNOWN Dexmedetomidine for Long-Term Sedation Investigators
Oct 15, 2013·Journal of Critical Care·Zhongheng ZhangXiao Xu
May 24, 2014·The Lancet. Respiratory Medicine·Carolyn S CalfeeUNKNOWN NHLBI ARDS Network
Jun 22, 2014·General Hospital Psychiatry·Jiaping Huai, Xiaohua Ye
Jun 27, 2015·BMC Medical Genomics·Akram AlyassDavid Meyre
Apr 2, 2016·Critical Care Medicine·Jesús VillarUNKNOWN Stratification and Outcome of Acute Respiratory Distress Syndrome (STANDARDS) Network
Dec 31, 2016·International Journal of Molecular Sciences·Michele UmbrelloDavide Chiumello
Mar 23, 2017·JAMA : the Journal of the American Medical Association·Yu KawazoeUNKNOWN Dexmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) Trial Investigators
Feb 22, 2018·JAMA : the Journal of the American Medical Association·Eddy FanArthur S Slutsky
Jun 6, 2018·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Wei ZhaoChang-Chun Cao
Jul 7, 2018·BMC Medical Research Methodology·Justin S MerkowKarsten Bartels
Aug 14, 2018·Journal of Biochemical and Molecular Toxicology·Yong ZhangLingzhi Yu

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