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右美托咪定对成年创伤性脑损伤患者住院时间和重症监护病房停留时间的影响:一项系统评价

Impact of Dexmedetomidine on Hospital and Intensive Care Unit Stay Duration in Adult Traumatic Brain Injury Patients: A Systematic Review.

作者信息

Alaifan Thamer, Sakhakhni Abdulrazak, Khojah Abdulrahman, Alraddadi Eman A, Alkhaibary Ali, Alqahtani Abdulaziz Mohammed

机构信息

Intensive Care Department, King Abdulaziz Medical City- Jeddah, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.

King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.

出版信息

Drug Healthc Patient Saf. 2025 Jul 11;17:157-171. doi: 10.2147/DHPS.S517119. eCollection 2025.

Abstract

BACKGROUND

Traumatic brain injury is a pressing public health issue worldwide that leads to profound disability and mortality. Medical guidelines recommend sedation and analgesia, with dexmedetomidine emerging as a promising option, given its unique pharmacological properties. However, the effect of dexmedetomidine in reducing the length of hospital stay in patients with traumatic brain injury remains unclear. This systematic review aimed to assess the effect of dexmedetomidine administration on traumatic brain injury management based on severity, with a specific focus on hospital and intensive care unit length of stay.

METHODS

A systematic search following the PRISMA guidelines identified relevant studies from various databases. Eligible studies involving adult patients with traumatic brain injury and dexmedetomidine interventions were selected and assessed for the risk of bias. The extracted data included the study characteristics, intervention details, and outcome measures.

RESULTS

Eight studies, three of which were randomized controlled trials, met the inclusion criteria. Dexmedetomidine has shown potential benefits in mitigating traumatic brain injury length of stay, particularly in patients with severe traumatic brain injury. However, the findings on hospital length of stay varied, preventing a definitive conclusion regarding the effectiveness of dexmedetomidine in reducing length of stay. Heterogeneity among the studies was the main factor in the reported variable results.

CONCLUSION

Dexmedetomidine has a promising role in traumatic brain injury management with evidence suggesting reduced intensive care unit length of stay with dexmedetomidine administration. A comprehensive understanding of dexmedetomidine dosing strategies and their long-term effects is crucial to optimize patient outcomes. A multifaceted approach to traumatic brain injury management will help enhance the therapeutic utility of dexmedetomidine and improve the care and outcomes of traumatic brain injury patients worldwide.

摘要

背景

创伤性脑损伤是全球紧迫的公共卫生问题,会导致严重残疾和死亡。医学指南推荐进行镇静和镇痛,鉴于右美托咪定独特的药理特性,它已成为一种有前景的选择。然而,右美托咪定对缩短创伤性脑损伤患者住院时间的效果仍不明确。本系统评价旨在评估根据严重程度给予右美托咪定对创伤性脑损伤治疗的效果,特别关注住院时间和重症监护病房住院时间。

方法

按照PRISMA指南进行系统检索,从各种数据库中识别相关研究。选择涉及成年创伤性脑损伤患者和右美托咪定干预措施的合格研究,并评估偏倚风险。提取的数据包括研究特征、干预细节和结局指标。

结果

八项研究符合纳入标准,其中三项为随机对照试验。右美托咪定在缩短创伤性脑损伤住院时间方面显示出潜在益处,尤其是在重度创伤性脑损伤患者中。然而,关于住院时间的研究结果各不相同,无法就右美托咪定在缩短住院时间方面的有效性得出明确结论。研究之间的异质性是报告结果存在差异的主要因素。

结论

右美托咪定在创伤性脑损伤治疗中具有重要作用,有证据表明给予右美托咪定可缩短重症监护病房住院时间。全面了解右美托咪定的给药策略及其长期影响对于优化患者结局至关重要。采用多方面方法管理创伤性脑损伤将有助于提高右美托咪定的治疗效用,并改善全球创伤性脑损伤患者的护理和结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baf8/12262089/6d781844c75a/DHPS-17-157-g0001.jpg

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