Effectiveness of Dexmedetomedine for Delirium and its Impact on Hemodynamics in Critically Ill Patients

右美托咪定治疗谵妄的疗效及其对危重患者血液动力学的影响

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Abstract

INTRODUCTION: Delirium is a state of behavioral changes like altered sensorium, agitation and fluctuating mental status which is commonly seen in critically ill patients. Dexemedetomedineis a specific and selective alpha-2 adrenoceptor agonist which binds to the presynaptic alpha 2 adrenoceptors and inhibits the release of norepinephrine and thereby terminate the propogation of pain signals. This drug is nowadays used in critically ill patients for prevention of delirium in critically ill patients. OBJECTIVES: this study aims to examine the effectiveness of dexmedetomidine for delirium and the impact on hemodynamics in critically ill patients of our population. MATERIALS AND METHODS: lt is a prospective observational study. A total of 80 patients of age group 18-70 years who were admitted in icu were recruited and they were randomly divided into two groups with 40 patients in each group. Inclusion criteria -patients aged 18-70 years, need mechanical ventilation, and who are intubated for more than 24 hrs. Treatment with dexmedetomidine was carried out in the investigation group, while midazolam were used in control group. A comparison was made on the antidelirium effect and the influence on hemodynamics between 2 groups in mechanical ventilation during sedation. RESULTS: The study is still ongoing and significant results were observed in variation of hemodynamic parameters including heart rate, respiratory rate, and blood oxygen saturation. No delirium occurred in the investigation group, when compared with 3 patients experiencing delirium symptom in the control group. DISCUSSIONS: With the preliminary findings of this study, it was found that dexmedetomedine is a good sedative drug for prevention of delirium in critically ill patients and these patients were hemodynamically more stable compared to the control group.

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