Effect of Dexmedetomidine on Duration of Mechanical Ventilation in Septic Patients

A Systematic Review and Meta-Analysis

Peifen Chen; Jihong Jiang; Yunhe Zhang; Guobao Li; Zhihui Qiu; Mitchell M. Levy; Baoji Hu

Disclosures

BMC Pulm Med. 2020;20(42) 

In This Article

Background

It had been reported that 21.38% of septic patients required mechanical ventilation in US.[1] However, patients with prolonged mechanical ventilation were associated with higher mortality, longer hospital stays and increased cost and other outcomes.[2,3] Appropriate sedation was required to reduce anxiety and stress caused by endotracheal intubation for septic patients.[4] It had been reported early deep sedation was associated with increased ventilation duration and mortality.[5]

Dexmedetomidine (DEX), a highly selective and potent α2 agonist, was used to achieve light sedation,[6] but the effect of DEX on mechanical ventilation in septic patients was controversial. A previous study demonstrated that septic patients sedated with DEX required less mechanical ventilation duration compared with that with lorazepam.[7] In contrast, a recent multi-center randomized clinical trial demonstrated that administration of DEX compared with non DEX (propofol, midazolam) resulted in neither a reduction in ventilator days nor an increase in ventilator-free days.[8] Therefore, in the present study, we performed a meta-analysis to determine whether sedation with DEX affected the duration of mechanical ventilation in adult septic patients.

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