지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
오류제보하기
Background : Dexmedetomidine is a selective α2 agonist with sedative, analgesic, and sympatholytic properties. Dexmedetomidine has cardiovascular risks such as hypotension and bradycardia. For this reason, the U.S. Food and Drug Administration (FDA) recommends the short-term use of dexmedetomidine less than 24 hours. Therefore, this study was aimed at analyzing the current status and risk factors of the cardiovascular side effects of dexmedetomidine. Methods : A retrospective chart review of all adult critically ill patients in the medical intensive care units who received dexmedetomidine from January 2016 to May 2017 was performed. The incidence, risk factors and prognosis of the cardiovascular adverse effects were analyzed. Results : The total number of patients was 135, and the mean hours of dexmedetomidine administration was 165 hours. A total of 102 patients (75.6%) developed cardiovascular side effects. Among them, hypotension occurred in 99 patients (73.3%), of which 53 patients (53.5%) developed hypotension within 24 hours. Bradycardia occurred in eight patients (5.9%), of which two patients (25.0%) developed bradycardia within 24 hours. Multivariate analysis of the risk factors for hypotension showed an association between hypotension and low baseline mean arterial pressure (MAP)(p=0.028), patients with acute respiratory distress syndrome (ARDS)(p=0.030) and those given norepinephrine (p=0.017). The incidence of hypotension was lower in patients with underlying hypertension (p=0.030). Univariate analysis of the risk factors for bradycardia showed that the incidence of bradycardia was higher in patients with lower baseline heart rates (p=0.033), higher body weight (p=0.008), and those undergoing hemodialysis (p=0.009). Also, there were no significant differences in the days of mechanical ventilation, the number of hospital days, and the mortality rate in patients with hypotension or bradycardia. Conclusion : Dexmedetomidine was associated with a higher incidence of cardiovascular side effects. Specifically, patients who were diagnosed with lower MAP, ARDS, or in combination with norepinephrine use were more likely to develop hypotension. Therefore, it is necessary to closely monitor cardiovascular adverse effects in patients with these risk factors.
목차
등록된 정보가 없습니다.
참고문헌 (21)
참고문헌 신청
Desbiens NA / 1996 / Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment / Crit Care Med 24(12):1953~1961
Friese RS / 2008 / Sleep and recovery from critical illness and injury : a review of theory, current practice, and future directions / Crit Care Med 36(3):697~705
Barr J / 2013 / Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit / Crit Care Med 41(1):263~306
Devlin JW / 2011 / Pharmacology of commonly used analgesics and sedatives in the ICU : benzodiazepines, propofol, and opioids / Anesthesiol Clin 29(4):567~585
Weerink MAS / 2017 / Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine / Clin Pharmacokinet 56(8):893~913
Friese RS / 2008 / Sleep and recovery from critical illness and injury : a review of theory, current practice, and future directions / Crit Care Med 36(3):697~705
Barr J / 2013 / Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit / Crit Care Med 41(1):263~306
Devlin JW / 2011 / Pharmacology of commonly used analgesics and sedatives in the ICU : benzodiazepines, propofol, and opioids / Anesthesiol Clin 29(4):567~585
Weerink MAS / 2017 / Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine / Clin Pharmacokinet 56(8):893~913
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