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Cycling of Dexmedetomidine May Prevent Delirium After Liver Transplantation.

Abstract：

BACKGROUND:Dexmedetomidine is useful for managing delirium. However, few studies have discussed the effect of dexmedetomidine on delirium after liver transplantation. Moreover, the studies have focused on treatment rather than prevention of delirium. This study found that dexmedetomidine cycling may prevent delirium by restoration of the circadian rhythm. METHODS:Of 38 patients who underwent liver transplantation between April 2013 and July 2016, 37 were retrospectively analyzed, except for 1 case of early mortality. The patients were divided into two groups, with 24 receiving dexmedetomidine for more than 3 days with cycling, and 13 receiving dexmedetomidine without cycling or for less than 3 days. Cycling was intended to restore circadian rhythm with high doses of dexmedetomidine at night and low doses during the day, while the patients remained intubated. After extubation, dexmedetomidine infusion was continued at night and discontinued during the day. The patients who used dexmedetomidine without cycling or for less than 3 days received dexmedetomidine without regard to circadian rhythm. RESULTS:Of the 24 patients who received dexmedetomidine for more than 3 days with cycling, 3 (12.5%) had delirium. In contrast, of the 12 patients who received dexmedetomidine without regard to circadian rhythm and the 1 who received dexmedetomidine cycling for less than 3 days, 6 (46.2%) had delirium (P = .042). Patients with hepatitis C showed higher prevalence of delirium (P = .022). CONCLUSION:Dexmedetomidine use for more than 3 days with cycling is useful for prevention of delirium after liver transplantation.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Hong KS,Kim NR,Song SH,Hong G

doi

10.1016/j.transproceed.2017.11.076

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

1080-1082

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)30090-3

journal_volume

50

pub_type

杂志文章

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