Ye Conglin, Yu Yang, Liu Yi
Department of Critical Care Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
The First Clinical Medical College of Gannan Medical University, Ganzhou, Jiangxi, China.
Front Med (Lausanne). 2025 Apr 17;12:1565098. doi: 10.3389/fmed.2025.1565098. eCollection 2025.
Acute respiratory distress syndrome (ARDS) continues to pose significant difficulties due to the scarcity of successful preventative and therapeutic measures. Recent clinical trials and experimental research have confirmed the lung-protective and anti-inflammatory properties of dexmedetomidine. The objective of this study was to examine the relationship between the use of dexmedetomidine and mortality outcomes in ICU patients with ARDS.
This study retrospectively examined data from the Medical Information Mart for Intensive Care (MIMIC) IV, focusing on individuals diagnosed with ARDS. The primary endpoint was the occurrence of death within 28 days after entering the ICU. To ensure a balanced cohort, we applied propensity score matching at a 1:1 ratio. Additionally, multivariable analysis was performed to mitigate the effects of confounding factors.
In this study, a cohort comprising 612 patients diagnosed with ARDS was investigated. Analysis using both univariate and multivariate Cox regression indicated significantly reduced 28-day and 90-day mortality rates in patients administered dexmedetomidine compared to those who were not given this treatment. Following adjustments for potential confounders using propensity score matching, these results were confirmed to be robust.
The results indicate an association between the administration of dexmedetomidine and lower mortality rates among severely ill ARDS patients. However, this result should be interpreted with cause because of a lot of missing data of potential risk factors for clinical outcomes. Nonetheless, it is imperative to perform further randomized controlled trials to corroborate this finding.
由于缺乏成功的预防和治疗措施，急性呼吸窘迫综合征（ARDS）仍然带来重大困难。最近的临床试验和实验研究证实了右美托咪定的肺保护和抗炎特性。本研究的目的是探讨右美托咪定的使用与ARDS重症监护病房（ICU）患者死亡率之间的关系。
本研究回顾性分析了重症监护医学信息数据库（MIMIC）IV中的数据，重点关注诊断为ARDS的患者。主要终点是进入ICU后28天内的死亡情况。为确保队列均衡，我们以1:1的比例应用倾向评分匹配。此外，进行多变量分析以减轻混杂因素的影响。
在本研究中，对612例诊断为ARDS的患者队列进行了调查。单变量和多变量Cox回归分析均表明，与未接受该治疗的患者相比，接受右美托咪定治疗的患者28天和90天死亡率显著降低。在使用倾向评分匹配对潜在混杂因素进行调整后，这些结果被证实是可靠的。
结果表明右美托咪定的使用与重症ARDS患者较低的死亡率之间存在关联。然而，由于临床结局潜在风险因素的大量数据缺失，这一结果应谨慎解读。尽管如此，进行进一步的随机对照试验以证实这一发现势在必行。
