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   Long Term Dexmedetomidine versus Midazolam in Patients Under Mechanical Ventilation: A Double blinded Randomized Clinical Trial  
   
نویسنده nader nader d. ,shadvar kamran ,pilehvar nina ,sanaie sarvin ,iranpour afshin ,hamishehkar hadi ,safiri saeid ,mahmoodpoor ata
منبع journal of cellular and molecular anesthesia - 2021 - دوره : 6 - شماره : 3 - صفحه:259 -268
چکیده    Background: dexmedetomidine has been approved for short-term analgesia and sedation of patients in the intensive care unit (icu). longer duration of sedation with dexmedetomidine is off-label, and its safety has not yet been tested. this study aims to examine the safety profile for long-term use of dexmedetomidine and compare it to midazolam (mid) based sedation in the icu.materials and methods: one hundred and one patients on mechanical ventilation were randomized to receive either dexmedetomidine 0.2-1.0 μg/kg/h or mid 20- 40 μg/kg/h in a double-blinded fashion to reach the target of -2 to 1 on the richmond agitation-sedation scale (rass). duration of mechanical ventilation was the primary endpoint; secondary endpoints included the occurrences of composite cardiac adverse event (ccae), bradycardia, hypotension, significant dysrhythmias, heart failure myocardial infarction or death within 28 days, icu length of stay, need for additive analgesic, time spent at target sedation, and delirium.results: the duration of mechanical ventilation and icu stay were almost two days shorter in the dexmedetomidine group (p= 0.002 and 0.001, respectively), but regarding ccae, sinus bradycardia occurred more frequently (p= 0.399), and mortality was similar in both groups (p=0.378).conclusion: our results confirmed the results of previous trials showing that long-term dexmedetomidine was comparable to benzodiazepines for the frequency of major complications in critically ill patients. physicians should weigh these benefits against the occurrence of significant bradycardia and hypotension.
کلیدواژه Dexmedetomidine ,Long-term Sedation ,Critical Care ,Mechanical ventilation
آدرس university at buffalo, department of anesthesiology, USA, tabriz university of medical sciences, school of medicine, department of anesthesiology and critical care medicine, Iran, university at buffalo, department of anesthesiology, USA, tabriz university of medical sciences, neurosciences research center, aging research institute, Iran, al zahra hospital, United Arab Emirates, tabriz university of medical sciences, iranian evidence-based medicine center of excellence, Iran, tabriz university of medical sciences, school of medicine, physical medicine and rehabilitation research center, aging research institute, department of community medicine, Iran, tabriz university of medical sciences, school of medicine, department of anesthesiology and critical care medicine, Iran
 
     
   
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