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右美托咪定在成人重症监护病房中的应用。

Use of dexmedetomidine in the adult intensive care unit.

作者信息

Wujtewicz Maria, Maciejewski Dariusz, Misiołek Hanna, Fijałkowska Anna, Gaszyński Tomasz, Knapik Piotr, Lango Romuald

机构信息

Department of Anaesthesiology and Intensive Therapy, Medical University of Gdańsk, Poland.

出版信息

Anaesthesiol Intensive Ther. 2013 Oct-Dec;45(4):235-40. doi: 10.5603/AIT.2013.0045.

Abstract

Sedation and analgesia, which are universally used in intensive care units (ICUs), provide patients with comfort and safety. The current trends aim at light sedation; the objective is to ensure the minimal sedation level for improving patients' autonomy and enabling the professional staff to assess the patients' neurological status and cognitive functions. Reports in the literature have indicated that a sedative or an entire sedation procedure can affect cognitive processes, the duration of mechanical ventilation and treatment outcomes in critically ill patients. At present, special attention is given to post-sedation delirium. Although sedatives differ in their uptake points, which can influence the quality of sedation, their common characteristic is substantial impairment of cognitive functions, memory and respiration. Alpha 2-adrenergic receptor agonists, which comprise a novel group of agents, are used frequently for sedation. One of these medications is dexmedetomidine, which is designed to sedate adult ICU patients who exhibit a score ≥ -3 according to the Richmond Agitation-Sedation Scale. Recent studies comparing the use of dexmedetomidine and the other sedative agents that are most commonly administered in ICUs demonstrated that the former largely fulfils the expectations of intensivists.

摘要

镇静和镇痛在重症监护病房(ICU)中被广泛使用,为患者提供舒适和安全保障。当前的趋势是采用浅镇静;目标是确保最低的镇静水平,以提高患者的自主性,并使专业医护人员能够评估患者的神经状态和认知功能。文献报道表明,镇静剂或整个镇静过程会影响重症患者的认知过程、机械通气时间和治疗结果。目前,人们特别关注镇静后谵妄。尽管镇静剂的作用点不同,这可能会影响镇静质量,但它们的共同特点是对认知功能、记忆和呼吸有实质性损害。α2肾上腺素能受体激动剂是一类新型药物,常用于镇静。其中一种药物是右美托咪定,它用于镇静根据里士满躁动镇静量表评分≥ -3的成年ICU患者。最近比较右美托咪定与ICU中最常用的其他镇静剂使用情况的研究表明,前者在很大程度上满足了重症监护医生的期望。

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