Comparing Longterm infusion of Dexmedetomidin versus midazolam in mechanically ventilated patients admitted to intensive care unit

Abstract

There are many controversies about the effect of dexmeditoimidine in comparison with other sedative drugs and insufficient evidence for the duration of treatment. Therefore, we decided to investigate the effect of long-term exposure to dimethomidine infusion with midazolam infusion in patients underwent mechanical ventilation in ICU. Materials and Methods: This study was a double-blind, randomized trial. All patients over 18 years of age requiring mechanical ventilation for more than 24 hours in ICU were randomly divided into two groups (dexmodetomidine group (0.4-4.8 μg/kg/h) and midazolam Dose of 0.4 mg/kg/h). In all patients, a washout period was performed from 7-9 a.m. to assess the patient's state of consciousness. Demographic data including age, sex, and patients' records were recorded. Possible complications including hypotension, bradycardia and RASS were evaluated every 4 hours. Finally, all the data entered the SPSS v19 statistical analysis program and we analyzed the data. Results: This study was performed on 101 patients hospitalized in ICU and 50 patients received midazolam and 51 patients with doxedetomidine. The mean age of patients in dexmeditomidine group was 59.11 ± 12.33 years and in midazolam group was 59.12 ± 13.48 years. The dominant gender in both groups was also men. It was also observed that after Washout, in the doxedetomidine group, 84.3% and midazolam group received 64% consciousness (P = 0.020). Also, more patients in the group receiving midazolam received the second drug for cirrhosis (P = 0.004). Also, the duration of desensitization in the dexmeditomidine group was 82.85 hours and in the midazolam group was 67.08 ± 11.88 (P = 0.000). Complications were also observed in 17.6% of the patients receiving dextromyidine and 11.7% of them had pneumonia. In the midazolam group, 34% had delirium and 20% had pneumonia. Also, 11.8% of patients with doxedetomidine and 18% of midazolam patients died during hospitalization (P = 0.378).