Ann Med Med Res | Volume 5, Issue 1 | Research Article | Open Access
Wei Zhao1,2, Congcong Zhao1, Lixia Liu1*, Zetong Gao1, Yuhong Chen1 and Zhenjie Hu1
1Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, China
2Department of Critical Care Medicine, The Shijiazhuang People’s Hospital, China
Background: Dexmedetomidine has been widely used clinically as a sedative drug. Studies have shown that dexmedetomidine not only has a sedative effect but can also have the protective effects on organ function by ameliorating stress in septic patients. Methods: By searching the PubMed, Embase, The Cochrane Library, and Web of Science databases, we collected prospective controlled trials that evaluated patients with sepsis who were treated with dexmedetomidine sedation, from the establishment of the database to December 23rd, 2020. RevMan 5.3 software was used for the meta-analysis. Binary variables were expressed by the Odds Ratio (OR) and 95% Confidence Interval (95% CI), and continuous variables were expressed as the Mean Differences (MD) and 95% CI. Results: We included 11 articles, including 10 randomized controlled studies and 1 prospective cohort study. A total of 1,245 patients with sepsis were included the meta-analysis results showed that dexmedetomidine did not reduce the sequential organ failure assessment score (MD= -0.63, 95% CI: -1.3~0.03, P=0.06), but it did reduce the score of kidney (MD= -0.56, 95% CI: -1.00~ -0.12, P=0.01). Dexmedetomidine significantly reduced the serum creatinine (MD= -0.35, 95% CI: -0.57~ -0.13, P=0.002) and cystatin C levels (MD= -0.59, 95% CI: -0.90~ -0.29, P<0.001), but it did not reduce the proportion of patients on continuous renal replacement therapy (OR=1.23, 95% CI: 0.70~2.17, P=0.47). Dexmedetomidine significantly reduced the 24-h vasopressor requirements (MD= -0.49, 95% CI: -0.68~ -0.31, P<0.001), but it did not significantly reduce the 24-h plasma lactic acid level (MD= -0.05, 95% CI: -0.35~ -0.25, P=0.77). The use of dexmedetomidine had no effect on the duration of mechanical ventilation (MD= -0.03, 95% CI: -1.13~1.06, P=0.95). Dexmedetomidine reduced the short-term mortality of patients with sepsis (OR= -0.58, 95% CI: 0.45~0.75, P<0.001) but no effect on the length of intensive care unit stay (MD= -0.08, 95% CI: -0.67~0.52, P=0.80). Conclusion: Dexmedetomidine can improve the renal function and reduce the mortality in septic patients, with no significant effects on other organ functions. Our results provided a promising therapeutic direction that requires further investigation.
Dexmedetomidine; Sepsis; Stress; Mortality; Organ function; Meta-analysis
Zhao W, Zhao C, Liu L, Gao Z, Chen Y, Hu Z. Effects of Dexmedetomidine on Organ Function and Mortality in Patients with Sepsis: A Systematic Review and Meta-Analysis. Ann Med Medical Res. 2022; 5: 1049..