Effects Of Sedation With Dexmedetomidine In The Pediatric Intensive Care Unit: A Meta-analysis Of Randomized Clinical Trials

Objective: dexmedetomidine is a new kind of alpha2adrenergic agonists. In our country formally applied tochildren’s time is short. During the period of care unit at present,if using dexmedetomidine to sedation will cause bad influence tochildren is not very clear. The aim of this study is through theMeta analysis to search During the period of sedation in thePediatric intensive care unit,whether dexmedetomidine will causeadverse impact on hemodynamics and breathing for children.In orderto provide theoretical basis for dexmedetomidine used in childrencalm in our country.Methods:We systematically searched the following databasesusing a combination of free text words and MeSH Terms: PubMed the Cochrane library EMBASE ISI Web of Knowledge Google scholar.There were no restrictions regarding the publication language.Then the reference lists of the trials were checked for further studies. We included all randomized controlled trialsinvestigating the sedation of dexmedetomidine in the Pediatricintensive care unit. According to breathing, heart rate, bloodpressure and oxygen saturation data collection can be divided intofour groups. SATA12and RM5.2software are adopted to improve thestatistics, in order to figure out the risk differences(RD) of Eachdata and with95%confidence interval (CI) to show the Merger value,then we mapping the forest and assess the heterogeneity.Result：We bring into six Randomized Controlled Trial, Atotal of365cases of pediatric patients. The analysis results showthat, In the aspect of children s hemodynamic,whether cardiacsurgical or non cardiac surgery group, during the period ofsedation in the Pediatric intensive care unit, there are no obviousdifference between dexmedetomidine group and no dexmedetomidinegroup in the adverse effects of dexmedetomidine on the heart rateand blood pressure, Results no statistical significance（P>O．05）.In the aspect of children s respiration, whether Mechanicalventilation group or non Mechanical ventilation group, during theperiod of sedation in the Pediatric intensive care unit, there are no obvious difference between dexmedetomidine group and nodexmedetomidine group in the adverse effects of dexmedetomidineon the respiration, Results no statistical significance（P>O．05）.At the same time, during the period of sedation in the Pediatricintensive care unit, there are no obvious difference betweendexmedetomidine group and no dexmedetomidine group in the adverseeffects of dexmedetomidine on the oxyhemoglobin saturation,Results also have no statistical significance（P>O．05）Conclusion: During the period of sedation by dexmedetomidinein the pediatric intensive care unit, In the aspect of children shemodynamic, dexmedetomidine has no obvious adverse effect onheart rate and blood pressure. But we need to take into accountthe dose-dependent of DEX, therefore, We suggest that,inaccordance with the recommended dosage for children and speedrange pump intravenous injection dexmedetomidine.But for childrenwith the possible of cardiovascular dysfunction, we should to bemore cautious, during the clinical sedation, appropriate to reducethe dose of drug use could be a better choose. Simultaneously, inthe aspect of children s respiration, dexmedetomidine has no obvious adverse effect on breath and oxygen saturation. Butconsider The particularity of pediatric,we suggest that, duringthe period of delivery,it is necessary to give children last breathmonitoring and low flow oxygen inhalation.