Immunosedation: a consideration for sepsis.
In a recent issue of Critical Care, Qiao and colleagues showed in a rat model of sepsis that dexmedetomidine and midazolam suppress the generation of pro-inflammatory mediators but the effects vary between agents. While dexmedetomidine limited apoptosis to a greater extent than midazolam, both agents significantly reduced short-term mortality compared with saline. This study, in addition to those by others, suggests there are disparate immunomodulating effects between sedatives. Clinical studies are warranted to investigate whether these effects impact outcomes of septic patients. Perhaps one day the choice of sedative in septic patients will not be based solely on sedative properties but rather immunosedative profiles.
MacLaren
Robert
R
University of Colorado Denver School of Pharmacy, Academic Office 1, C238-L15, 12631 East 17th Avenue, Aurora, CO 80045, USA. rob.maclaren@ucdenver.edu
D020927:Dexmedetomidine / Q000494:pharmacology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D007107:Immune System / Q000187:drug effects*; D008874:Midazolam / Q000494:pharmacology; D018805:Sepsis / Q000188:drug therapy*
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam