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Brain Inj. 2013;27(13-14):1617-22. doi: 10.3109/02699052.2013.831130. Epub 2013 Oct 8.

Effects of dexmedetomidine on cerebral blood flow in critically ill patients with or without traumatic brain injury: a prospective controlled trial.

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1
Intensive Care Unit, Shanghai Sixth People's Hospital, Medical College of Shanghai Jiaotong University , Shanghai , PR China .

Abstract

STUDY OBJECTIVE:

To examine the effect of dexmedetomidine on CBF in critical ill patients with or without TBI.

RESEARCH DESIGN:

Prospective controlled trial (ISRCTN57998533).

METHODS:

Fifteen patients without TBI and 20 patients with TBI with a Glasgow Coma Scale score of 4-14 were assigned to CON or TBI groups, respectively. All patients received 1 μg kg(-1) dexmedetomidine infused over 10 minutes, followed by a 0.4 μg kg(-1)h(-1) continuous infusion for 60 minutes. Blood pressure was maintained at the pre-sedation level with dopamine for all patients. The CBF and cerebral metabolic rate equivalent (CMRe) were measured before sedation and 70 minutes after dexmedetomidine administration.

RESULTS:

Dexmedetomidine administration significantly decreased CBF in patients of the CON group (difference = 3.3 ml s(-1), 95% confidence interval [CI] = 0.92-5.7 ml s(-1), p = 0.008), without altering the CMRe and CMRe/CBF ratio. The dexmedetomidine-induced change of CBF, CMRe and CMRe/CBF was not significant in the TBI group. The percentage of CBF reduction was greater in the CON group than in the TBI group (difference = 13.9%, 95% CI = 5.5-22.2%, p = 0.002).

CONCLUSIONS:

Dexmedetomidine may be used in patients with TBI without risk of affecting brain oxygenation.

PMID:
24102571
DOI:
10.3109/02699052.2013.831130
[Indexed for MEDLINE]
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