Guo F, Wang Q, Yan C Y, Huang H Y, Yu X, Tu L Y
Intensive Care Unit, Sir Run Run Shaw Hospital Affiliated School of Medicine, Zhejiang University, Hangzhou 310016, China.
Zhonghua Yi Xue Za Zhi. 2016 Jun 14;96(22):1758-61. doi: 10.3760/cma.j.issn.0376-2491.2016.22.010.
To evaluated the 3 sedation regimen for patients with septic shock.
The randomized controlled trial wan conducted. Forty-five patients with septic shock were assigned to 3 groups (midazolam group, propofol group, and dexmedetomidine group) randomly. The basic characteristics of patients, the duration of mechanical ventilation, the length of stay in the ICU, the death rate for 28 days and the regulatory cell (Treg) in peripheral blood were observed. The control group for Treg test was consisted of 20 healthy volunteers.
There were no significant differences between the groups in the death rate for 28 days and the duration of mechanical ventilation. The length of stay in the ICU in dexmedetomidine group was shorter than that in midazolam group(15.21±5.55 vs.19.67±5.7 days, P<0.05). The Treg of 3 groups was higher than that of control group (11.82±4.93 vs.3.69±1.71, 11.30±3.42 vs. 3.69±1.71, 12.83±6.17 vs. 3.69±1.71) at the first day of ICU. The Treg after 3 ICU days in dexmedetomidine group and the Treg after 5 ICU days in propofol group and in midazolam group have no difference with control group.
For the patients with septic shock, dexmedetomidine could decrease the length of stay in the ICU and the duration of immune suppression.
评估3种镇静方案用于感染性休克患者的效果。
进行随机对照试验。45例感染性休克患者被随机分为3组（咪达唑仑组、丙泊酚组和右美托咪定组）。观察患者的基本特征、机械通气时间、重症监护病房（ICU）住院时间、28天死亡率及外周血调节性T细胞（Treg）。Treg检测的对照组由20名健康志愿者组成。
28天死亡率和机械通气时间在各组间无显著差异。右美托咪定组的ICU住院时间短于咪达唑仑组（15.21±5.55天 vs. 19.67±5.7天，P<0.05）。在入住ICU的第1天，3组的Treg均高于对照组（11.82±4.93 vs. 3.69±1.71，11.30±3.42 vs. 3.69±1.71，12.83±6.17 vs. 3.69±1.71）。右美托咪定组入住ICU 3天后的Treg、丙泊酚组和咪达唑仑组入住ICU 5天后的Treg与对照组无差异。
对于感染性休克患者，右美托咪定可缩短ICU住院时间及免疫抑制持续时间。
