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Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis

BACKGROUND: Because 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...

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Autores principales: Chen, Peifen, Jiang, Jihong, Zhang, Yunhe, Li, Guobao, Qiu, Zhihui, Levy, Mitchell M., Hu, Baoji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026965/
https://www.ncbi.nlm.nih.gov/pubmed/32066417
http://dx.doi.org/10.1186/s12890-020-1065-6
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author Chen, Peifen
Jiang, Jihong
Zhang, Yunhe
Li, Guobao
Qiu, Zhihui
Levy, Mitchell M.
Hu, Baoji
author_facet Chen, Peifen
Jiang, Jihong
Zhang, Yunhe
Li, Guobao
Qiu, Zhihui
Levy, Mitchell M.
Hu, Baoji
author_sort Chen, Peifen
collection PubMed
description BACKGROUND: Because 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. METHODS: Databases 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. RESULTS: Four 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. CONCLUSION: Administration 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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spelling pubmed-70269652020-02-24 Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis Chen, Peifen Jiang, Jihong Zhang, Yunhe Li, Guobao Qiu, Zhihui Levy, Mitchell M. Hu, Baoji BMC Pulm Med Research Article BACKGROUND: Because 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. METHODS: Databases 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. RESULTS: Four 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. CONCLUSION: Administration 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. BioMed Central 2020-02-17 /pmc/articles/PMC7026965/ /pubmed/32066417 http://dx.doi.org/10.1186/s12890-020-1065-6 Text en © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Chen, Peifen
Jiang, Jihong
Zhang, Yunhe
Li, Guobao
Qiu, Zhihui
Levy, Mitchell M.
Hu, Baoji
Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
title Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
title_full Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
title_fullStr Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
title_full_unstemmed Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
title_short Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
title_sort effect of dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026965/
https://www.ncbi.nlm.nih.gov/pubmed/32066417
http://dx.doi.org/10.1186/s12890-020-1065-6
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