Effectiveness of dexmedetomidine for delirium and its impact on hemodynamics in critically ill patients

Abstract

Aim/Background: Delirium is common in critically ill patients. For its treatment along with other sedatives, dexmedetomidine has also been prescribed by the clinicians.  However, the outcomes with its use are less well-defined by any study in local population. We aimed to study its effectiveness for delirium and the impact on hemodynamics in critically sick patients of our population.

Methodology: It was a cross-sectional, prospective observational study conducted on 212 participants after ethical review committee approval at our hospital. Heart rate, systolic and diastolic blood pressures and Richmond Agitation Sedation Scale (RASS) scores were recorded before starting dexmedetomidine and within one hour of starting the drug. More than 10% decrease in heart rate (HR) or systolic or diastolic blood pressure was considered as an impact on hemodynamic parameters. An achievement of RASS of -2 was considered as effectiveness of drug.

 Results: There was a mean drop of HR by 13.78 ± 18.58 beats/min (14.49%) after starting dexmedetomidine. Mean systolic blood pressure drop was 10.99 ± 20.67 mmHg (9.16%), and mean drop in diastolic blood pressure was 4.958 ± 12.53 mmHg after dexmedetomidine use. The mean value of RASS score achieved on dexmedetomidine was -2.

 Conclusion: Our study concluded the effectiveness of dexmedetomidine as light sedation for delirium. It significantly impacted on hemodynamic parameters. Its impact on heart rate was more pronounced as compared to systolic and diastolic blood pressures.

Key words: Dexmedetomidine; Critical care; Delirium; Hemodynamics

Citation: Kausar S, Yasin I, Ahsan I, Rais Z. Effectiveness of dexmedetomidine for delirium and its impact on hemodynamics in critically ill patients. Anaesth. pain intensive care 2020;24(6):645-649

Received: 14 June 2020, Reviewed: 24 August, 19 October 2020, Accepted: 26 October 2020