Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
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右美托咪定对脓毒症患者机械通气持续时间的影响：系统评价和荟萃分析
DOI：
10.1186/s12890-020-1065-6
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发表时间：
2019-06
影响因子：
3.1
通讯作者：
Hu Baoji
中科院分区：
文献类型：
--
作者：
Chen Peifen;Jiang Jihong;Zhang Yunhe;Li Guobao;Qiu Zhihui;Levy Mitchell M.;Hu Baoji
由于其镇痛和轻度镇静的特性，高选择性α 2肾上腺素能受体激动剂右美托咪定（DEX）已被建议用于治疗脓毒症患者，但其对机械通气持续时间的影响尚不清楚。本研究回顾了DEX的现有文献，并确定其对成人脓毒症患者通气时间的影响。方法应用PubMed、科克伦和EMBASE数据库至2019年1月20日，无语言限制。检索策略如下：脓毒症或脓毒症和机械通气和右美托咪定。两名作者独立筛选标题、摘要甚至文章，以满足纳入标准。此外，还参考了相关文章或综述的参考文献。结果共纳入4个研究，共349例患者。三项试验（267例患者）揭示了DEX对机械通气持续时间的影响，两项试验（264例患者）显示了无呼吸机天数，四项试验（334例患者）显示了28天死亡率。分析结果表明，DEX与机械通气持续时间无显著差异（MD 0.65，95%CI，-0.13至1.42，P = 0.10）。但无呼吸机天数差异有统计学意义（MD 3.57，95%CI 0.26~6.89，P = 0.03）和28天死亡率（RR 0.61，95%CI，0.49~0.94，P = 0.02）结论脓毒症患者给予地塞米松镇静与机械通气时间无关，但增加了无呼吸机天数，降低了28天死亡率。
BackgroundBecause of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients.MethodsDatabases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0.ResultsFour studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, − 0.13 to 1.42,P= 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89,P= 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94,P= 0.02) in the septic patients.ConclusionAdministration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality.
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影响因子：
5.3
作者：
通讯作者：
--
影响因子：
--
作者：
Adil Rafiq Rather;B. Kasana
通讯作者：
Adil Rafiq Rather;B. Kasana
影响因子：
2.9
作者：
Choi HS
通讯作者：
Choi HS
影响因子：
--
作者：
Loss SH;de Oliveira RP;Maccari JG;Savi A;Boniatti MM;Hetzel MP;Dallegrave DM;Balzano Pde C;Oliveira ES;Höher JA;Torelly AP;Teixeira C
通讯作者：
Teixeira C
DOI：
10.1164/rccm.201203-0522oc
发表时间：
2012-10-15
影响因子：
24.7
作者：
Shehabi, Yahya;Bellomo, Rinaldo;Weisbrodt, Leonie
通讯作者：
Weisbrodt, Leonie