title: Effects of different doses of dexmedetomidine on heart rate and blood pressure in intensive care unit patients.
abstract: The aim of the present study was to observe and compare the sedative effect of different doses of DEX on heart rate (HR) and blood pressure (BP) in critically ill patients admitted to intensive care units (ICUs). The study included patients that were retained in ICUs and required sedation between January and March 2014. Patients were excluded if they had a BP of >200 mmHg, a HR of <60 bpm or were in a state of shock. The included patients were randomized into three groups: Group A, 1.0 µg/kg/10 min DEX; group B, 0.5 µg/kg/10 min DEX; and group C, 0.4 µg/kg/h DEX. After receiving these initial designated doses of DEX via an intravenous (IV) infusion pump for 10 min, the patients were maintained continuously at an identical dose of 0.4 µg/kg/h DEX. Ramsay score, HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), breathing rate (BR) and peripheral capillary oxygen saturation (SpO2) were recorded prior to the IV pump infusion and at 2, 4, 6, 8, 10, 60, 120, 180 and 240 min following infusion. Patients in groups A and B achieved sedation more rapidly compared with those in group C (P<0.05). HR decreased more significantly at 8 and 60 min after the initial IV pump infusion with DEX in groups A and B compared with group C (P<0.05). SBP decreased significantly at 10 min after IV pump infusion in group A compared with groups B and C (P<0.05). No significant difference existed in the SBP reduction trend between the three groups during the maintenance period. Therefore, the routine dose of DEX (0.4 µg/kg/h) provides an ideal sedative effect in ICU patients. The recommended loading dose for a more rapid sedation is 0.5 µg/kg/h. High loading doses of DEX via IV pump infusion should be avoided in elderly individuals, patients with acute exacerbation of chronic obstructive pulmonary disease and anemic patients, in whom combination medication, such as midazolam or propofol, may be considered when necessary.
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Ruilan
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jin
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Yongbin
authors.initials: Y
authors.lastname: Qian
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Peijie
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Rui
authors.initials: R
authors.lastname: Tian
authors.affiliation: Department of Emergency, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
keywords: bradycardia; dexmedetomidine; intensive care; sedation