右美托咪定联合苯二氮䓬类药物镇静治疗酒精戒断谵妄患者。
Dexmedetomidine in addition to benzodiazepine-based sedation in patients with alcohol withdrawal delirium.
机构信息
aDepartment of Medicine, Division of Emergency Medicine, Helsinki and Uusimaa District University Hospital, Helsinki bDepartment of Emergency Medicine, Middle Finland Central Hospital, Jyväskylä cNational Institute for Health and Welfare, Helsinki, Finland.
出版信息
Eur J Emerg Med. 2013 Dec;20(6):425-7. doi: 10.1097/MEJ.0b013e32835c53b3.
Alcohol withdrawal delirium (AWD) is often refractory to conventional medication. We report a prospective series of patients treated with α2-agonist dexmedetomidine added to conventional sedation. Eighteen patients with AWD were diagnosed by Confusion assessment method for ICU score. Treatment, complications, length of stay (LOS) in ICU and hospital were recorded. In addition, hospital and 1-year mortality were assessed. Dexmedetomidine was given for 23.9 (18.4) h [mean (SD)]. All the patients also received benzodiazepines but three patients were given haloperidole. No patient was intubated. The maximum infusion rate of dexmedetomidine was 1.5 (1.2) µg/kg/h. Time to resolution of AWD was 3.8 (1.3) days. The ICU LOS was 7.1 (2.7) days and in-hospital LOS 12.1 (4.5) days. No adverse events were observed although one patient died from acute pancreatitis. The use of dexmedetomidine in AWD seems safe but warrants further studies.
酒精戒断谵妄（AWD）通常对常规药物治疗有抗性。我们报告了一组前瞻性接受α2-激动剂右美托咪定联合常规镇静治疗的患者。18 例 AWD 患者通过 ICU 意识模糊评估法（CAM-ICU）确诊。记录了治疗、并发症、ICU 和住院时间（LOS），并评估了住院和 1 年死亡率。右美托咪定治疗持续时间为 23.9（18.4）h[均值（SD）]。所有患者均接受苯二氮䓬类药物治疗，但 3 例患者加用氟哌啶醇。无患者需要插管。右美托咪定的最大输注速率为 1.5（1.2）µg/kg/h。AWD 缓解时间为 3.8（1.3）天。ICU LOS 为 7.1（2.7）天，住院 LOS 为 12.1（4.5）天。尽管有 1 例患者死于急性胰腺炎，但未观察到不良事件。右美托咪定在 AWD 中的应用似乎是安全的，但需要进一步研究。
Zotero 插件