Effects From Continuous Infusions of Dexmedetomidine and Propofol on Hemodynamic Stability in Critically Ill Adult Patients With Septic Shock

PURPOSE: To compare the development of clinically significant hemodynamic event (ie, hypotension or bradycardia) in adults with septic shock receiving either propofol or dexmedetomidine.

MATERIALS AND METHODS: A retrospective cohort study of adults with septic shock admitted to an intensive care unit (ICU) at an academic medical center between July 2013 and July 2017.

RESULTS: Patients in the propofol (n = 35) and dexmedetomidine (n = 37) groups developed a clinically significant hemodynamic event at similar frequencies (31.4 vs 29.7%, P = .99). All patients with an event experienced hypotension, whereas 2 (5.4%) patients in the dexmedetomidine group also experienced bradycardia. Most patients in both groups (70% vs 90%) received an escalating sedative dose, and almost half (42.9%) in the dexmedetomidine group had the sedative dosage increased more frequently than every 30 minutes. Patients in both groups had similar ICU (24.1 vs 24.3 days, P = .98) and hospital (37.9 vs 29.7 days, P = .29) lengths of stay. There was no difference in median time to hemodynamic event between the groups (propofol 1 hour [interquartile range, IQR: 0.5-9.9] vs dexmedetomidine 2 hours [IQR: 1.5-11.1 hours], P = .85).

CONCLUSION: Patients with septic shock receiving propofol or dexmedetomidine experienced similar rates of clinically significant hemodynamic events. Most patients did not experience an event and those who did most frequently did so in the first couple of hours of therapy.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:35

Enthalten in:

Journal of intensive care medicine - 35(2020), 9 vom: 27. Sept., Seite 875-880

Sprache:

Englisch

Beteiligte Personen:

Nelson, Kristen M [VerfasserIn]
Patel, Gourang P [VerfasserIn]
Hammond, Drayton A [VerfasserIn]

Links:

Volltext

Themen:

67VB76HONO
Dexmedetomidine
Hypnotics and Sedatives
Journal Article
Observational Study
Propofol
Sedation
Septic shock
YI7VU623SF

Anmerkungen:

Date Completed 30.04.2021

Date Revised 15.04.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1177/0885066618802269

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM28896618X