ICU sedation with dexmedetomidine after severe traumatic brain injury.

Abstract:

OBJECTIVE:To comprehensively describe the use of dexmedetomidine in a single institutional series of adult ICU patients with severe TBI. This study describes the dexmedetomidine dosage and infusion times, as well as the physiological parameters, neurological status and daily narcotic requirements before, during and after dexmedetomidine infusion. METHODS:This study identified 85 adult patients with severe TBI who received dexmedetomidine infusions in the Trauma ICU at Vanderbilt University Medical Center between 2006-2010. Demographic, haemodynamic, narcotic use and sedative use data were systematically obtained from the medical record and analysed for changes associated with dexmedetomidine infusion. RESULTS:During infusion with dexmedetomidine, narcotic and sedative use decreased significantly (p < 0.001 and p < 0.05). Median MAP, SBP, DBP and HR also decreased significantly during infusion when compared to pre-infusion values (p < 0.001). Despite the use of dexmedetomidine, RASS and GCS scores improved from pre-infusion to infusion time periods. CONCLUSIONS:The findings demonstrate that initiation of dexmedetomidine infusion is not associated with a decline in neurological functioning in adults with severe TBI. Although there was an observed decrease in haemodynamic parameters during infusion with dexmedetomidine, the change was not clinically significant and the requirements for narcotics and additional sedatives were minimized.

journal_name

Brain Inj

journal_title

Brain injury

authors

Humble SS,Wilson LD,Leath TC,Marshall MD,Sun DZ,Pandharipande PP,Patel MB

doi

10.1080/02699052.2016.1187289

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

1266-70

issue

10

eissn

0269-9052

issn

1362-301X

journal_volume

30

pub_type

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