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右美托咪定:在烧伤重症监护病房中的当前作用

Dexmedetomidine: Current Role in Burn ICU.

作者信息

Scibelli G, Maio L, Sasso M, Lanza A, Savoia G

机构信息

Anaesthesia and Intensive Care ASL Caserta.

Anaesthesia and Intensive Care Department - AORN "A. Cardarelli"-Napoli.

出版信息

Transl Med UniSa. 2017 Jul 1;16:1-10. eCollection 2017 Jan.

Abstract

Dexmedetomidine (DEX) is a relativelyrecent a-adrenergic agonist which provides sedation, anxiolysis and analgesia with much less respiratory depression than other sedatives. These characteristics have implemented the use of the drug in the ICUs in order to achieve the target of a "arousable sedation", thanks to its significant manageability. Its sedative-analgesic properties are also particularly suitable for use in burn ICUs, both adult and pediatric, which is why the current Guidelines have recognized a central role in the management of these categories of patients. Finally, DEX has showed significant anti-inflammatory effect both in animal models and in preliminary clinical trials, reducing vasopressor requirements and main mediators levels of the systemic inflammatory response involved in sepsis and similar processes, suggesting its use for improved outcome in ICU septic patients.

摘要

右美托咪定(DEX)是一种相对较新的α-肾上腺素能激动剂,它能提供镇静、抗焦虑和镇痛作用,且呼吸抑制比其他镇静剂少得多。由于其具有显著的可控性,这些特性促使该药物在重症监护病房(ICU)中得以应用,以实现“可唤醒镇静”的目标。其镇静镇痛特性也特别适用于成人和儿童烧伤ICU,这就是为什么当前指南已认可其在这类患者管理中的核心作用。最后,右美托咪定在动物模型和初步临床试验中均显示出显著的抗炎作用,可降低血管升压药需求以及脓毒症和类似过程中全身炎症反应的主要介质水平,这表明其可用于改善ICU脓毒症患者的预后。

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