Document Detail


Comparative effects of propofol vs dexmedetomidine on cerebrovascular carbon dioxide reactivity in patients with septic shock.
MedLine Citation:
PMID:  18178608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of sedative drugs is reportedly related to altered cerebrovascular CO2 reactivity. The present study examined the comparative effects of propofol vs dexmedetomidine on cerebrovascular CO2 reactivity in patients with septic shock. METHODS: A total of 20 patients with septic shock who required mechanical ventilation were included in this study. Sedation during mechanical ventilation was maintained using either propofol or dexmedetomidine. A 2.5 MHz pulsed transcranial Doppler probe was attached to the head of the patient at the right temporal window for continuous measurement of mean blood flow velocity in the middle cerebral artery (V(mca)). After establishing baseline values of V(mca) and cardiovascular haemodynamics, end-tidal CO2 was increased by decreasing ventilatory frequency by 5-8 bpm. RESULTS: The absolute and relative CO2 reactivity values in patients with septic shock were lower for both propofol and dexmedetomidine than those for control groups, with significant differences between these values in the two septic shock groups (absolute CO2 reactivity in septic shock under propofol: 2.6 (sd 0.3) cm s(-1) mm Hg(-1); absolute CO2 reactivity in septic shock under dexmedetomidine: 2.0 (0.3) cm s(-1) mm Hg(-1); P<0.01). CONCLUSIONS: This study showed that cerebrovascular CO2 reactivity was lower under dexmedetomidine sedation than under propofol sedation during almost identical sedation in patients with septic shock.
Authors:
Y Kadoi; S Saito; C Kawauchi; H Hinohara; F Kunimoto
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-01-04
Journal Detail:
Title:  British journal of anaesthesia     Volume:  100     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-23     Completed Date:  2008-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  224-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. kadoi@med.gunma-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity / drug effects
Carbon Dioxide / metabolism
Cerebrovascular Circulation / drug effects*
Conscious Sedation / methods
Dexmedetomidine / pharmacology*
Humans
Hypnotics and Sedatives / pharmacology*
Middle Aged
Middle Cerebral Artery / physiopathology,  ultrasonography
Propofol / pharmacology*
Prospective Studies
Respiration, Artificial
Shock, Septic / physiopathology*
Ultrasonography, Doppler, Transcranial
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 113775-47-6/Dexmedetomidine; 124-38-9/Carbon Dioxide; 2078-54-8/Propofol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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