Title |
Effects of dexmedetomidine and propofol on patient-ventilator interaction in difficult-to-wean, mechanically ventilated patients: a prospective, open-label, randomised, multicentre study
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Published in |
Critical Care, July 2016
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DOI | 10.1186/s13054-016-1386-2 |
Pubmed ID | |
Authors |
Giorgio Conti, Vito Marco Ranieri, Roberta Costa, Chris Garratt, Andrew Wighton, Giorgia Spinazzola, Rosario Urbino, Luciana Mascia, Giuliano Ferrone, Pasi Pohjanjousi, Gabriela Ferreyra, Massimo Antonelli |
Abstract |
Dexmedetomidine can be used for sedation of mechanically ventilated patients and has minor respiratory effects. The aim of this study was to compare the incidence of patient-ventilator dyssynchronies during sedation with dexmedetomidine or propofol. We conducted a multicentre, prospective, open-label, randomised clinical trial, comparing dexmedetomidine with standard propofol sedation at three intensive care units of university hospitals in Italy. Twenty difficult-to-wean patients for whom the first weaning trial had failed and who were on pressure support ventilation were randomised to receive sedation with either dexmedetomidine or propofol at a similar level of sedation (Richmond Agitation-Sedation Scale [RASS] score +1 to -2). The asynchrony index (AI) was calculated using tracings of airflow, airway pressure and electrical activity of the diaphragm sampled at 0, 0.5, 1, 2, 6, 12, 18 and 24 h. The mean AI was lower with dexmedetomidine than with propofol from 2 h onwards, although the two groups significantly differed only at 12 h (2.68 % vs 9.10 %, p < 0.05). No further difference was observed at 18 and 24 h. When sedation with propofol and dexmedetomidine was compared at similar RASS scores of patients in whom first weaning trial had failed, the AI was lower with dexmedetomidine than with propofol, and this difference was statistically significant at 12 h. These results suggest that sedation with dexmedetomidine may offer some advantages in terms of patient-ventilator synchrony. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 3 | 7% |
Argentina | 3 | 7% |
Colombia | 3 | 7% |
United Kingdom | 3 | 7% |
Spain | 3 | 7% |
Netherlands | 2 | 5% |
Mexico | 2 | 5% |
Chile | 2 | 5% |
Malaysia | 1 | 2% |
Other | 5 | 11% |
Unknown | 17 | 39% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 30 | 68% |
Practitioners (doctors, other healthcare professionals) | 7 | 16% |
Scientists | 4 | 9% |
Science communicators (journalists, bloggers, editors) | 3 | 7% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Italy | 1 | <1% |
Unknown | 122 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 23 | 19% |
Student > Postgraduate | 18 | 15% |
Other | 13 | 11% |
Professor > Associate Professor | 9 | 7% |
Student > Bachelor | 9 | 7% |
Other | 28 | 23% |
Unknown | 23 | 19% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 63 | 51% |
Nursing and Health Professions | 13 | 11% |
Pharmacology, Toxicology and Pharmaceutical Science | 6 | 5% |
Biochemistry, Genetics and Molecular Biology | 4 | 3% |
Business, Management and Accounting | 2 | 2% |
Other | 6 | 5% |
Unknown | 29 | 24% |