Castillo J, Bisbe E, Sierra P, Escolano F, Castaño J
Servicio de Anestesiología y Reanimación, Unidad de Cuidados Intensivos, Hospital de la Esperanza, Barcelona.
Rev Esp Anestesiol Reanim. 1995 Oct;42(8):303-5.
To analyze the dose of midazolam needed for induction and maintenance of sedation, as well as its hemodynamic repercussions in critically ill patients requiring mechanical ventilation.
We studied 20 adult patients requiring mechanical ventilation for respiratory failure in the intensive care unit. An induction dose of 1 mg/min midazolam was given until the patient became drowsy (eyes closed but opened again) and this level of sedation was maintained by continuous intravenous perfusion. We calculated induction dose, maintenance dose and their correlation with age, weight, general state (APACHE-II index), liver function, hematocrit and blood chemistry.
The induction dose was 4.76 +/- 3.4 mg and correlated with weight and plasma albumin levels. The maintenance dose of 6.4 +/- 3.97 mg/h did not correlate with any of the parameters studied. A statistically significant reduction in arterial pressure was observed.
The sedation dose of midazolam in critically ill patients is related to weight and plasma albumin levels. Recovery time is related to mean maintenance dose.
分析重症监护病房中需要机械通气的危重病患者诱导和维持镇静所需咪达唑仑的剂量，以及其对血流动力学的影响。
我们研究了20例在重症监护病房因呼吸衰竭需要机械通气的成年患者。给予咪达唑仑诱导剂量为1mg/min，直至患者嗜睡（眼睛闭合但又睁开），并通过持续静脉输注维持该镇静水平。我们计算了诱导剂量、维持剂量及其与年龄、体重、一般状况（急性生理与慢性健康状况评分系统II [APACHE-II]指数）、肝功能、血细胞比容和血液化学指标的相关性。
诱导剂量为4.76±3.4mg，与体重和血浆白蛋白水平相关。维持剂量为6.4±3.97mg/h，与所研究的任何参数均无相关性。观察到动脉压有统计学意义的降低。
危重病患者咪达唑仑的镇静剂量与体重和血浆白蛋白水平有关。恢复时间与平均维持剂量有关。
