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Meta-Analysis
. 2020 Feb 17;20(1):42.
doi: 10.1186/s12890-020-1065-6.

Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis

Peifen Chen  1 , Jihong Jiang  2 , Yunhe Zhang  3 , Guobao Li  4 , Zhihui Qiu  5 , Mitchell M Levy  6 , Baoji Hu  7
Affiliations
Meta-Analysis

Effect of Dexmedetomidine on duration of mechanical ventilation in septic patients: a systematic review and meta-analysis

Peifen Chen et al. BMC Pulm Med. .

Abstract

Background: Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients.

Methods: Databases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0.

Results: Four studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, - 0.13 to 1.42, P = 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89, P = 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94, P = 0.02) in the septic patients.

Conclusion: Administration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality.

Keywords: Dexmedetomidine; Duration of mechanical ventilation; Sepsis; Systematic review and meta-analysis.

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Conflict of interest statement

All authors declare no conflict of interest here.

Figures

Fig. 1
Fig. 1
Flow diagram of the study retrieved, excluded, assessed and included
Fig. 2
Fig. 2
Risk of bias summary
Fig. 3
Fig. 3
Risk of bias graph
Fig. 4
Fig. 4
Comparison of duration of mechanical ventilation between patients in the DEX group and Propofol group
Fig. 5
Fig. 5
Comparison of duration of mechanical ventilation between patients in the DEX group and Midazolam group
Fig. 6
Fig. 6
Secondary outcome. DEX was associated with a reduction of ventilator-free days
Fig. 7
Fig. 7
Secondary outcome. DEX improved short-term mortality
Fig. 8
Fig. 8
Sensitivity analysis
Fig. 9
Fig. 9
Funnel plot of the duration of ventilator-free days. The hollow dots and dotted line indicate individual studies and 95% confidence intervals, respectively
Fig. 10
Fig. 10
Funnel plot of mortality. The hollow dots and dotted line indicate individual studies and 95% confidence intervals, respectively
See this image and copyright information in PMC

Comment in

  • [Focus general intensive care medicine. Intensive care studies from 2020/2021].
    Dietrich M, Beynon C, Fiedler MO, Bernhard M, Kümpers P, Hecker A, Jungk C, Nusshag C, Michalski D, Brenner T, Weigand MA, Reuß CJ. Dietrich M, et al. Anaesthesist. 2021 Oct;70(10):888-894. doi: 10.1007/s00101-021-00976-x. Epub 2021 Jul 29. Anaesthesist. 2021. PMID: 34324037 Free PMC article. German. No abstract available.

References

    1. Dhital R, Basnet S, Poudel DR. Predictors and outcome of invasive mechanical ventilation in hospitalized patients with sepsis: data from National Inpatient Sample. J Community Hosp Intern Med Perspect. 2018;8(2):49–52. doi: 10.1080/20009666.2018.1450592. - DOI - PMC - PubMed
    1. Loss SH, de Oliveira RP, Maccari JG, Savi A, Boniatti MM, Hetzel MP, et al. The reality of patients requiring prolonged mechanical ventilation: a multicenter study. Rev Bras Ter Intensiva. 2015;27(1):26–35. doi: 10.5935/0103-507X.20150006. - DOI - PMC - PubMed
    1. Lone NI, Walsh TS. Prolonged mechanical ventilation in critically ill patients: epidemiology, outcomes and modelling the potential cost consequences of establishing a regional weaning unit. Crit Care. 2011;15(2):R102. doi: 10.1186/cc10117. - DOI - PMC - PubMed
    1. Choi HS. Respiratory review of 2013: critical care medicine. Tuberc Respir Dis. 2013;75(1):1–8. doi: 10.4046/trd.2013.75.1.1. - DOI - PMC - PubMed
    1. Shehabi Y, Bellomo R, Reade MC, Bailey M, Bass F, Howe B, et al. Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. Am J Respir Crit Care Med. 2012;186(8):724–731. doi: 10.1164/rccm.201203-0522OC. - DOI - PubMed