Journal of critical care · 2026
Hemodynamic impact of dexmedetomidine in critically ill patients with and without cirrhosis: A retrospective cohort study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Conroy Grace M, Yerke Jason R, Rudoni Michael A, Kapoor Aanchal, Bass Stephanie N
Аннотация
PURPOSE: This study aims to compare adverse hemodynamic effects of dexmedetomidine in critically ill patients with and without cirrhosis.
MATERIALS AND METHODS: We conducted a retrospective, observational cohort study of adult patients who received at least 2 h of a dexmedetomidine infusion while admitted to a medical or surgical intensive care unit between November 2018 and December 2021 at multiple hospitals within the Cleveland Clinic. Patients were divided into cohorts with and without cirrhosis. The primary objective was to compare the incidence of adverse hemodynamic events between groups, defined as incidence of bradycardia during dexmedetomidine infusion. Secondary outcomes included incidence of severe bradycardia and hypotension within 24 h of dexmedetomidine initiation. A multivariable logistic regression was performed for bradycardia and hypotension during drug infusion.
RESULTS: In total, 157 patients were included; 37 patients with and 120 without cirrhosis. Patients with cirrhosis had similar baseline heart rate but higher cardiac SOFA (0 [0,3] vs. 0 [0,0]; p = 0.01). Patients with cirrhosis demonstrated a higher incidence of bradycardia (40.5% vs. 22.5%; RR 1.9 [95% CI 1.1-3.2]). After adjustment, the odds of developing bradycardia during dexmedetomidine infusion were greater in the cirrhosis group (adjusted OR 2.24 [95% CI 0.96-5.21]). The cirrhosis group had increased odds of developing hypotension in the first 24 h (adjusted OR 2.36 [95% CI 0.99-5.63]).
CONCLUSIONS: Dexmedetomidine use was associated with higher rates of bradycardia, severe bradycardia, and hypotension in patients with cirrhosis. Future research is needed on dexmedetomidine use based on severity of liver disease.
MATERIALS AND METHODS: We conducted a retrospective, observational cohort study of adult patients who received at least 2 h of a dexmedetomidine infusion while admitted to a medical or surgical intensive care unit between November 2018 and December 2021 at multiple hospitals within the Cleveland Clinic. Patients were divided into cohorts with and without cirrhosis. The primary objective was to compare the incidence of adverse hemodynamic events between groups, defined as incidence of bradycardia during dexmedetomidine infusion. Secondary outcomes included incidence of severe bradycardia and hypotension within 24 h of dexmedetomidine initiation. A multivariable logistic regression was performed for bradycardia and hypotension during drug infusion.
RESULTS: In total, 157 patients were included; 37 patients with and 120 without cirrhosis. Patients with cirrhosis had similar baseline heart rate but higher cardiac SOFA (0 [0,3] vs. 0 [0,0]; p = 0.01). Patients with cirrhosis demonstrated a higher incidence of bradycardia (40.5% vs. 22.5%; RR 1.9 [95% CI 1.1-3.2]). After adjustment, the odds of developing bradycardia during dexmedetomidine infusion were greater in the cirrhosis group (adjusted OR 2.24 [95% CI 0.96-5.21]). The cirrhosis group had increased odds of developing hypotension in the first 24 h (adjusted OR 2.36 [95% CI 0.99-5.63]).
CONCLUSIONS: Dexmedetomidine use was associated with higher rates of bradycardia, severe bradycardia, and hypotension in patients with cirrhosis. Future research is needed on dexmedetomidine use based on severity of liver disease.