Dexmedetomidine in COVID-19: probing promises with prudence!

Magoon, Rohan

doi:10.1016/j.ajem.2020.10.034

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…An improved comprehension of the COVID-19 pathobiophysiology should be closely backed by the meticulous investigation of the mechanistically related and specific drug therapies aimed at ameliorating the root cause of the disease process. Amidst the intensifying research challenges in the ongoing pandemic where a part of fraternity is impressing upon the fact that the plural of anecdotes does not classify as data [13] , [14] , the importance of rapidly responding to the dynamic challenging clinical landscape cannot be overemphasized wherein a judicious application of more familiar medications such as iMil can be helpful in mitigating the ever growing concerns of COVID-19 attributable morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Inhaled milrinone for sick COVID-19 cohort: A pathophysiology driven hypothesis!

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Inhaled milrinone for sick COVID-19 cohort: A pathophysiology driven hypothesis!

et al. 2021

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“…Generally, the studies we mentioned above report that DEX can be a beneficial option in patients with severe COVID-19 especially to increase the patients' tolerance to NIMV support and long periods of PP. However, one letter to the editor drew attention to DEX-associated hyperpyrexia as a side effect and dosage of infusion as a concern for the withdrawal phenomenon (20). The author recommends using DEX with caution because of this potential side effect and narrow therapeutic index.…”

Section: Discussionmentioning

confidence: 99%

Does the Use of Dexmedetomidine Affect the Outcomes in Patients With Severe Covid-19?

İşsever

Genç

Çekiç

et al. 2021

Preprint

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Objective: Dexmedetomidine (DEX) is a highly selective α2-adrenoceptor agonist that is increasingly used in the daily practice of intensive care units (ICUs) with its sedative, analgesic, anxiolytic, and immunoprotective effects. In this study, we aimed to analyze whether Dexmedetomidine improves the outcomes in patients treated in ICU. Design: A retrospective study Place and Duration of Study: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to February 2021 Methodology: The medical records of the patients were analyzed retrospectively. We included 134 patients in the study, in 45 of whom the treatment regimen included dexmedetomidine and 89 of whom were not treated with dexmedetomidine. Patients treated with DEX were defined as the “patient group”, whereas patients not treated with DEX were defined as “control group” and the parameters were compared between these groups. Obtained data were analyzed in the biostatistical program. Results: The median age of all patients was 64 and 62.7% of them were male. No significant difference was found between the groups in terms of median ages (p>0.05). The patients with diabetes mellitus (DM), congestive heart failure (CHF), and undergoing insulin treatment were significantly less treated with DEX (p=0.04, p=0.03, and p=0.016 respectively) whereas intravenous immunoglobulin (IVIG) therapy was found to be more frequently applied to the patient group (p=0.043). The median duration between ICU admission and the time of intubation was 4 days for the control group whereas it was 1 day for the patient group and the difference was strongly significant (p=0.000, p<0.001). The other analyses concerning lab parameters, mortality rates, intubation rates and durations, applied treatments, and comorbidities revealed no significant difference between the groups. Conclusion: Our study revealed that DEX therapy can help us to gain time before intubation however can not reduce mortality rates in severe COVID-19.

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The effectiveness of dexmedetomidine in patients with severe COVID-19

Andreichenko

Bychinin

Mandel

et al. 2021

Journal of Clinical Practice

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Rationale: Mortality in patients with severe COVID-19 remains high. Finding therapies that can improve the outcome in these patients is an urgent function. Objective: To evaluate the clinical efficacy of dexmedetomidine in the results of complex treatment with a severe course of COVID-19. Materials and Methods: The retrospective study included 50 adult patients with severe COVID-19 admitted to the intensive care unit (ICU). The primary outcome of the study was the incidence of delirium. The secondary results of the study were dynamics of gas exchange indicators (PaO2 and PaCO2) and inflammatory markers (C-reactive protein (CRP), procalcitonin, lymphocyte count and neutrophil-lymphocyte ratio (NLR)) for 3 and 5 days of treatment, as well as the duration of mechanical ventilation (MV), length of stay (LOS) in the ICU and hospital and mortality. Results: The incidence of delirium did not differ between the dexmedetomidine group and the control group (41% and 48%, respectively; p = 0,661). The LOS in the ICU and the hospital, as well as the duration of MV, was comparable between the groups. However, hospital mortality in the dexmedetomidine treatment group was lower than in the control group (10,3% and 42,9%, respectively; p = 0,008). The addition of dexmedetomidine to the complex of therapy did not affect the change in blood gas, but contributed to an increase in the number of lymphocytes (p = 0,006) and a decrease in NLS (p = 0,002) by the fifth day of treatment. At the same time, no significant changes in CRP and procalcitonin levels were observed. Conclusion: Therapy with dexmedetomidine was not accompanied by a decrease in the frequency of delirium, LOS in the ICU and the hospital, and the duration of MV in patients with severe COVID-19. Prospective randomized trials are needed to confirm the beneficial effects of dexmedetomidine on the immune system and mortality.

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Dexmedetomidine in COVID-19: probing promises with prudence!

Cited by 3 publications

References 11 publications

Inhaled milrinone for sick COVID-19 cohort: A pathophysiology driven hypothesis!

Inhaled milrinone for sick COVID-19 cohort: A pathophysiology driven hypothesis!

Does the Use of Dexmedetomidine Affect the Outcomes in Patients With Severe Covid-19?

The effectiveness of dexmedetomidine in patients with severe COVID-19

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