右美托咪定对新生儿镇静、疼痛、呼吸状态及心血管系统的影响。
Dexmedetomidine's effect on neonatal sedation, pain, respiratory status and cardiovascular system.
作者信息
Makoni Marjorie M, Sierra-Strum Ivonne, Bischoff Adrianne R, Miller Jamie L, DeShea Lise, Beasley William Howard, Szyld Edgardo
机构信息
Section of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Los Angeles General Medical Center and Children's Hospital Los Angeles, Los Angeles, CA, USA.
出版信息
J Perinatol. 2025 Sep 4. doi: 10.1038/s41372-025-02339-5.
OBJECTIVE
To describe the effects of dexmedetomidine on sedation, pain, respiratory status, and hemodynamics in neonates.
METHODS
A retrospective study of 206 infants in a level IV NICU (2016-2021) receiving continuous dexmedetomidine infusion. Pain/sedation scores, BP, vasopressor and inotrope score (VIS), and concomitant sedatives/analgesics (CSA) were recorded before and every 3-4 h for 24 h.
RESULTS
Median PMA:32 weeks. Hypotension occurred in 26%, primarily in infants <32weeks PMA, correlating with higher VIS and CSA. CSA use significantly predicted vasopressors/inotrope use.
CONCLUSION
Dexmedetomidine, with CSA, increases cardiovascular instability in preterm infants who have unique myocardial structure and function and therefore higher vulnerability.
CLINICAL TRIAL REGISTRATION (IF ANY): None (not applicable).
目的
描述右美托咪定对新生儿镇静、疼痛、呼吸状态和血流动力学的影响。
方法
对2016年至2021年在四级新生儿重症监护病房（NICU）接受持续右美托咪定输注的206例婴儿进行回顾性研究。在给药前以及之后的24小时内，每3 - 4小时记录一次疼痛/镇静评分、血压、血管升压药和血管活性药物评分（VIS）以及同时使用的镇静剂/镇痛药（CSA）。
结果
胎龄中位数为32周。26%的婴儿出现低血压，主要发生在胎龄小于32周的婴儿中，且与较高的VIS和CSA相关。CSA的使用显著预示了血管升压药/血管活性药物的使用。
结论
右美托咪定联合CSA会增加具有独特心肌结构和功能、因而更易出现问题的早产儿的心血管不稳定性。
临床试验注册情况（如有）：无（不适用）。
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