Dexmedetomidine for sedation during nonivasive ventilation in acute respiratory syndrome patients

Бєлка, К. Ю.; Kuchyn, Iurii

doi:10.1183/13993003.congress-2018.oa5411

Cited by 3 publications

(4 citation statements)

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“…Dexmedetomidine increased the risk for bradycardia and the effect was most pronounced in two studies with low risk of bias in a meta-analysis (RR =5.33; 95% CI: 1.52-18.66) (45).…”

Section: Respiratory and Cardiovascular Issues In Icu Patientsmentioning

confidence: 88%

“…Only two RCTs reported about NIV failure and need for mechanical ventilation in patients treated with dexmedetomidine (45,46). The risk of NIV failure was reduced by the use of dexmedetomidine, with an absolute risk reduction (ARR) of 16% (95% CI: 20-10%), a finding which correlates to a RR of 0.54 (95% CI: 0.41-0.71) (45). Duration of mechanical ventilation was reduced even when low doses of ≤0.7 µg/kg/h were given (RR =0.53; 95% CI: 0.39-0.72).…”

Section: Respiratory and Cardiovascular Issues In Icu Patientsmentioning

confidence: 99%

“…For the latter, the reduction in mean duration of NIV was −31.18 h (95% CI: −41.07 to −21.28). Furthermore, the use of dexmedetomidine reduced the ARR for acquiring pneumonia by 16% (95% CI: 11-19%) (45,46).…”

Section: Respiratory and Cardiovascular Issues In Icu Patientsmentioning

confidence: 99%

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Dexmedetomidine: a magic bullet on its way into palliative care—a narrative review and practice recommendations

Gaertner¹,

Fusi-Schmidhauser²

2022

Ann Palliat Med

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Background and Objective: Dexmedetomidine is a potent adrenergic alpha-2 receptor agonist. It was first approved for sedation for mechanically ventilated patients. Being a sedative medication that is not associated with respiratory depression and holding analgesic properties fosters the interest for this drug in the palliative care field. The primary objectives of this review were to identify the key indications for the real-world use of dexmedetomidine in palliative care and other disciplines.Methods: A narrative review after extensive PubMed search was performed from 1950 to present on October 21st 2021. The language of the publications was restricted to English, German, French and Italian.Key Content and Findings: (I) Current dexmedetomidine use. There is a growing body of evidence that dexmedetomidine may reduce the incidence and severity of delirium, reduce opioid-consumption and postoperative nausea in intensive care settings. It is also used to facilitate withdrawal from different substances (alcohol, opioids, heroin). Concerning safety aspects of the drug, some studies reported an increased rate of serious cardiovascular events in patients with pre-existing heart conditions due to bradycardia and arterial hypo-and hypertension. Since the drug has a main hepatic metabolism, dose reduction is mandatory in patients with hepatic impairment. (II) Dexmedetomidine and palliative care. There have been sporadic case reports about the successful use of dexmedetomidine in palliative care. Indications for symptom control included sedation for hyperactive delirium, cancer pain, opioid-induced-hyperalgesia, dystonia, cough, vomiting, shivering and dyspnea. It is mainly applied via the intravenous (i.v.), subcutaneous, but also nasal and, buccal routes. Admixture ("syringe-driver") studies showed that dexmedetomidine is compatible with morphine, hydromorphone, hyoscine and haloperidol. In 2021, a first prospective cohort study became available. Here, the authors reported promising result for dexmedetomidine use in hyperactive terminal delirium for reducing delirium intensity and agitation. Especially the unique "conscious sedation"or "awake sedation" that allows patients to arouse easily under sedation and report comfort or distress was discussed by the authors. Conclusions:In this review, we present the main findings for dexmedetomidine from palliative care settings and other disciplines. The potential benefits and criticalities of the drug are discussed and practical recommendations for its use are provided.

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“…Dexmedetomidine increased the risk for bradycardia and the effect was most pronounced in two studies with low risk of bias in a meta-analysis (RR =5.33; 95% CI: 1.52-18.66) (45).…”

Section: Respiratory and Cardiovascular Issues In Icu Patientsmentioning

confidence: 88%

Section: Respiratory and Cardiovascular Issues In Icu Patientsmentioning

confidence: 99%

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Dexmedetomidine: a magic bullet on its way into palliative care—a narrative review and practice recommendations

Gaertner¹,

Fusi-Schmidhauser²

2022

Ann Palliat Med

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“…Another indication for NIV is acute respiratory insufficiency. B ielka et al [81] compared adults with acute respiratory insufficiency due to ARDS (mild–moderate according to the Berlin definition) on NIV with and without the use of dexmedetomidine for sedation. This intervention led to improved patient comfort, and lower incidences of delirium and post-traumatic stress disorders after ICU discharge.…”

Section: Hot Topics In Nivmentioning

confidence: 99%

European Respiratory Society International Congress 2018: highlights from Assembly 2 on respiratory intensive care

et al. 2019

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The respiratory intensive care Assembly of the European Respiratory Society is proud to present a summary of several important sessions held at the International Congress in Paris in 2018. For the highly esteemed reader who may have missed the Congress, a concise review was written on three topics: the state-of-the-art session on respiratory critical care, hot topics in weaning and the best abstracts in noninvasive ventilation.

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Respiratory Management of Acute Cardiogenic Pulmonary Edema: A Review

Barkhordari¹,

Khan²,

Shafiee³

2020

AACC

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Acute cardiogenic pulmonary edema (ACPE) is a common and life-threatening condition among patients with heart failure. The literature contains a large number of reviews discussing the respiratory management aspect of this entity; nonetheless, none of these studies has thoroughly probed into the respiratory management of different cardiac pathologies ending with ACPE, together with the different modes of ventilation and invasive and noninvasive ventilation in the same discussion. The present review seeks to discuss the physiologic bases of lung-heart interactions, the hemodynamic effects of positive pressure ventilation, and the results of studies on the effects of the various modes of ventilation having been used until the writing of this article. Also discussed herein are ACPE in different heart pathologies and their respective ventilator management, as well as the indications, complications, and contraindications of noninvasive positive pressure ventilation and intermittent mandatory ventilation.

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Dexmedetomidine for sedation during nonivasive ventilation in acute respiratory syndrome patients

Cited by 3 publications

References 0 publications

Dexmedetomidine: a magic bullet on its way into palliative care—a narrative review and practice recommendations

Dexmedetomidine: a magic bullet on its way into palliative care—a narrative review and practice recommendations

European Respiratory Society International Congress 2018: highlights from Assembly 2 on respiratory intensive care

Respiratory Management of Acute Cardiogenic Pulmonary Edema: A Review

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