Effects Of Dexmedetomidine And Propofol On Hemodynamic In Adult Patients With Septic Shock

Objective: To compare the occurrence of clinically significant hemodynamic events(i.e.hypotension or bradycardia)in adult patients with septic shock treated with dexmedetomidine or propofol.Methods: adult septic shock patients with ICU were selected into the study.After routine ECG monitoring and invasive blood pressure monitoring,they were sedated with dexmedetomidine or propofol.RASS sedation scale was used to evaluate the sedation degree of septic shock patients included in the study,and whether hemodynamic events occurred were recorded at the same time.The data were analyzed to determine the effect of dexmedetomidine or propofol on hemodynamic stability in patients with septic shock.Results: The frequency of clinically significant hemodynamic events was similar in the dexmedetomidine group(n=37)and the propofol group(n=35)(34.0% vs 37.2%,P > 0.05).Among them,14 patients(37.8%)in the dexmedetomidine group developed both hypotension and bradycardia,and 2 patients(5.4%)only developed bradycardia.Patients with hemodynamic events in the propofol group experienced hypotension and bradycardia.1/4 of patients increased the pump dose of sedatives before occurrence(23.4% vs 20.9% P > 0.05).Almost half of the patients in the dexmetomidine group(40.4%)increased the dose more than every 30 minutes.There was no significant difference in the length of stay in ICU(24.6 days vs 24.0 days,P > 0.05)and hospitalization time(29.5 days vs 37.6 days,P > 0.05)between the two groups.There was no difference in the median time of hemodynamic events between the two groups.Propofol for 1 hour(IQR: 0.5-9.9 h)and dexmetomidine for 2h(IQR: 1.5-11.1 h,P >0.05).Conclusion: Patients with septic shock who received dexmedetomidine or propofol sedation had a similar incidence of hemodynamic events.Most of the patients had no adverse events,which occurred most frequently in the first few hours of treatment.