Effects of dextrmedetomidine with different target sedation depth on non invasive ventilation in AECOPD patients with respiratory failure
Objective To observe the effect of dexmedetomidine sedation at different depths on patients with AECOPD complicated with respiratory failure undergoing non-invasive positive pressure ventilation(NIPPV).Methods From August 2021 to March 2023,136 AECOPD patients with respiratory failure were admitted.A control group of 40 patients were treated with conventional drugs and NIPPV.Sedative group A was treated with dexmedetomidine hydrochloride micro pump intravenous infusion,with a Ramsay sedation score of 2～3 points as the target adjusted dose.Sedative group B was treated with dexmedetomidine hydrochloride sedation score of 3～4 points as the target adjusted dose.The heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP)and arterial blood gas indexes of the patients in three groups before and 24 hours after treatment were compared.The time to use the machine,sputum volume,and dexmedetomidine dosage within 24 hours after the start of NIPPV in three groups were compared.The incidence of intubation,delirium and cardiovascular adverse events were compared.Results After treatment,RR,MAP,HR,PaO2 and PaCO2 in three groups of patients were significantly improved compared to before treatment.The improvement of the above indicators in the sedative A and B groups after treatment was better than in the control group,with all the differences statistically significant(P<0.05).The HR of sedative group B was lower than that of sedative group A(P<0.05).The time to use the machine in sedative group A and group B was longer than in the control group,and the dosage of dexmedetomidine in sedative group B was higher than that in sedative group A(P<0.05).There was no significant difference in sputum volume among the three groups(P>0.05).The tracheal intubation rate and delirium incidence rate in the control group were higher than those in the sedative A and B groups,and the incidence of cardiovascular adverse events in the sedative B group was higher than that in the control group and sedative A group(P<0.05).Conclusion The use of dexmedetomidine sedation during non-invasive ventilation in AECOPD patients can significantly improve patient compliance,reduce tracheal intubation rate,and reduce delirium.Adjusting the dosage with a Ramsay sedation score of 2-3 can reduce the incidence of cardiovascular adverse events.
NETL
NSTL
万方数据
