药物流行病学杂志2024,Vol.33Issue(4) :441-448.DOI:10.12173/j.issn.1005-0698.202311046

右美托咪定用于ICU机械通气患者的快速卫生技术评估

Dexmedetomidine for sedation in the ICU patients on mechanical ventilation:a rapid health technology assessment

李文萍 邓平洋 杨林 杜宪 蔡江霞
药物流行病学杂志2024,Vol.33Issue(4) :441-448.DOI:10.12173/j.issn.1005-0698.202311046

右美托咪定用于ICU机械通气患者的快速卫生技术评估

Dexmedetomidine for sedation in the ICU patients on mechanical ventilation:a rapid health technology assessment

李文萍 1邓平洋 2杨林 2杜宪 1蔡江霞1
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作者信息

  • 1. 巴音郭楞蒙古自治州人民医院药学部(新疆库尔勒 841000)
  • 2. 巴音郭楞蒙古自治州人民医院烧伤整形外科(新疆库尔勒 841000)
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摘要

目的 快速评估右美托咪定用于重症监护室(ICU)机械通气患者的有效性、安全性和经济性,为临床和决策者提供参考.方法 计算机检索PubMed、Embase、Cochrane Library、CNKI、WanFang Data数据库和国内外卫生技术评估(HTA)机构官方网站,纳入右美托咪定对比安慰剂或其他传统镇静药用于ICU机械通气患者的HTA报告、系统评价/Meta分析及药物经济学研究,检索时限均为从建库至2023年6月14日.由2名研究者独立筛选文献、提取资料和评价纳入研究的质量后,采用定性合成的方法汇总纳入研究的结果.结果 共纳入13篇文献,包含10篇系统评价/Meta分析,3篇经济学研究.有效性方面,与安慰剂或其他传统镇静药相比,右美托咪定用于ICU机械通气患者的镇静,患者机械通气时间更短、ICU住院时间更短.安全性方面,右美托咪定可减少谵妄发生率,但可能会增加心动过缓的发生率.经济性分析结果显示,右美托咪定组药物治疗费用更高,但可以降低总的ICU花费.结论 右美托咪定用于ICU机械通气患者镇静具有良好的有效性和安全性,同时具有良好的经济性,但纳入的经济学研究以国外研究为主,国内经济性方面有待进一步论证.

Abstract

Objective To rapidly evaluate the efficacy,safety,and economics of dexmedetomidine in patients on mechanical ventilation in intensive care unit(ICU),and to provide references for clinical and decision makers.Methods To search PubMed,Embase,Cochrane Library,CNKI,WanFang Data databases and official websites of domestic and foreign Health Technology assessment(HTA)institutions from the inception to June 14,2023.HTA reports,systematic reviews/Meta-analyses,and pharmacoeconomic studies of patients with mechanical ventilation in ICU compared with dexmedetomidine versus placebo or other traditional sedatives were included.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,and descriptive analyzed and summarised the results.Results A total of 13 literatures were included,including 10 systematic reviews/Meta-analyses and 3 economic studies.The analysis results of effectiveness showed that compared with placebo or other traditional sedatives,the use of dexmedetomidine in the sedation of mechanically ventilated patients in the ICU was associated with a shorter duration of mechanical ventilation and a shorter length of stay in the ICU.The analysis results of safety displayed treatment with dexmedetomidine could reduce the incidence of delirium,but may increase the incidence of bradycardia.The results of the economic analysis showed that the dexmedetomidine group had a higher cost of medication,but a lower overall ICU cost.Conclusion Dexmedetomidine has good efficacy,safety and economics in the sedation of patients on mechanical ventilation in ICU,but the economic studies included in the search were mainly foreign studies,and domestic economy studies needs to be further demonstrated.

关键词

右美托咪定/重症监护室/机械通气/镇静/快速卫生技术评估

Key words

Dexmedetomidine/Intensive care unit/Mechanical ventilation/Sedation/Rapid health technology assessment

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基金项目

巴音郭楞蒙古自治州科学技术研究计划(2022)(202209)

出版年

2024
药物流行病学杂志
中国药学会 武汉医药(集团)股份有限公司

药物流行病学杂志

CSTPCD
影响因子:0.746
ISSN:1005-0698
参考文献量10
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