Effect of dexmedetomidine on perioperative hemodynamics and organ protection in children with congenital heart disease: A randomized controlled trial.
Medicine (Baltimore)
; 100(1): e23998, 2021 Jan 08.
Article
en En
| MEDLINE
| ID: mdl-33429762
ABSTRACT
BACKGROUND:
This study aimed to investigate the effects of dexmedetomidine (Dex) on hemodynamics and organ protection in congenital heart disease (CHD) children who underwent open-heart surgery under cryogenic cardiopulmonary bypass.METHODS:
Ninety children were randomly allocated to group C (0.9% saline 0.2âµg/kg/hour), group D1 (Dex 0.2âµg/kg/hour), and group D2 (Dex 0.4âµg/kg/hour) (nâ=â30 per group). All participants received fentanyl, propofol and 1% sevoflurane for anesthesia induction. Hemodynamic data were measured from T0 (before the induction) to T7 (30 minutes after extubation). The difference of arterial internal jugular vein bulbar oxygen difference and cerebral oxygen extraction ratio were calculated according to Fick formula. Enzyme-linked immunosorbent assay was performed to detect the serum myocardial, brain and kidney injury markers. The incidence of acute kidney injury (AKI) was calculated by serum creatinine level. Tracheal extubation time, postoperative pain score and emergence agitation score were also recorded.RESULTS:
Compared with group C, group D1, and D2 exhibited reduction in hemodynamic parameters, myocardial and brain injury indicators, and tracheal extubation time. There were no significant differences in blood urea nitrogen and neutrophil gelatinase-associated lipocalin or incidence of AKI among the 3 groups. Besides, the incidence of tachycardia, nausea, vomiting and moderate agitation, and the FLACC scale in group D1 and D2 were lower than those in group C. Moreover, Dex 0.4âg/kg/hour could further reduce the dosage of fentanyl and dopamine compared with Dex 0.2âg/kg/hour.CONCLUSIONS:
Dex anesthesia can effectively maintain hemodynamic stability and diminish organ injuries in CHD children.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dexmedetomidina
/
Defectos de los Tabiques Cardíacos
Tipo de estudio:
Clinical_trials
Límite:
Child
/
Child, preschool
/
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2021
Tipo del documento:
Article