Dexmedetomidine vs Midazolam for Sedation in Mechanically Ventilated Children: A Randomized Controlled Trial

Gulla, Krishna Mohan; Sankar, Jhuma; Jat, Kana Ram; Kabra, Sushil Kumar; Lodha, Rakesh

doi:10.1007/s13312-021-2124-7

Cited by 11 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have evaluated levels of sedation between drugs; however, it is difficult to draw comparisons as various control arms and sedation assessment tools were used. [28] , [29] , [30] A recent study demonstrated the ability to achieve light sedation quicker with dexmedetomidine in a general PICU cohort 4 and however found that one-third of the dexmedetomidine group also required additional sedatives to achieve light sedation. 31 In the current study, we did not observe an increase in the use of additional sedatives in the dexmedetomidine group.…”

Section: Discussionmentioning

confidence: 99%

Perioperative dexmedetomidine compared to midazolam in children undergoing open-heart surgery: A pilot randomised controlled trial

Long

Gibbons

Stöcker

et al. 2023

Critical Care and Resuscitation

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Perioperative dexmedetomidine compared to midazolam in children undergoing open-heart surgery: A pilot randomised controlled trial

Long

Gibbons

Stöcker

et al. 2023

Critical Care and Resuscitation

View full text Add to dashboard Cite

“…A smooth operation may thus be hindered by secretion disorders stimulated by the sympathetic nervous system, together with increased blood pressure and heart rate. 1 , 12 …”

Section: Discussionmentioning

confidence: 99%

“…A previous study reported that dexmedetomidine may be a possible alternative to midazolam, with better sedative effects and safety. 1 …”

Section: Introductionmentioning

confidence: 99%

Effect of dexmedetomidine on hemodynamics in patients undergoing hysterectomy: a meta-analysis and systematic review

Zhang

2021

J Int Med Res

View full text Add to dashboard Cite

Objective We conducted a meta-analysis and systematic review to evaluate the effects of dexmedetomidine on the hemodynamics of patients undergoing hysterectomy. Methods We searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases for clinical randomized controlled trials (RCTs) that allowed direct or indirect comparisons of hemodynamic indicators. We also searched nine English-language databases up to April 2021 to identify relevant research. The Cochrane risk-of-bias tool for RCTs was applied to assess the methodological quality of the eligible studies. The meta-analysis was conducted using RevMan 5.4 software. Results Nine trials were included in this systematic review. The effect of dexmedetomidine on heart rate during surgery was significantly smaller than that of other sedatives. Intraoperative systolic and diastolic blood pressure and mean arterial pressure were more stable in the dexmedetomidine group compared with the control group. The postoperative modified Observer’s Assessment of Alertness Score was also better in the dexmedetomidine compared with the control group. Conclusions Dexmedetomidine increases hemodynamic stability in patients undergoing hysterectomy, reduces the cardiovascular stress response during surgery, and effectively prevents postoperative adverse reactions, with good safety.

show abstract

“…This pattern of maturation allows our hypothesis to be valid. It should be noted here that when characterizing hepatic blood ow in pediatric populations, assumptions need to be made that: blood ow per unit of liver weight in children and adults is the same (Edginton et al, 2006); the percentage of cardiac output to the liver remains constant with age (Arya and Ramji, 2001). On this basis, since the hepatic blood ow of the pediatric population is di cult to obtain, referring to the physiological values of hepatic blood ow and liver weight, we can replace QH in the formula with liver weight here, which has negligible in uence on the results.…”

Section: Scaling Hepatic Clearancementioning

confidence: 99%

Extrapolation of midazolam disposition in neonates using physiological based pharmacokinetic/pharmacodynamic (PBPK/PD) modelling

Zhao,

Zhou,

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: To explore the feasibility of model simulation research strategies for dose optimization in the neonatal populations. Using midazolam as a model drug, a PBPK/PD model was established to simulated and optimize the dosing regimen for sedation in the neonatal population. Methods: Firstly, an adult PBPK/PD model was established. Secondly, the research strategy of extrapolating adult drug use data to newborns was applied. The adult PBPK/PD model was extrapolated to the neonatal population according to the maturation formula of plasma albumin and metabolic enzyme CYP3A4/5. The robustness of the neonatal model was evaluated using clinical data from different age stratification. The neonatal PBPK/PD model was then used to simulate the dosage regimen of midazolam for sedation in newborns. Results: Individualized validation in adults showed that 95.1% of the predicted concentration values were within two-fold, and all the predicted AUC values were within two-fold; the extrapolated neonatal model showed that about 84.4% of the predicted concentration values were within two-fold, the AAFE value of the overall model was < 2, and the AFE value was between 0.5–1.5; the validated neonatal PBPK/PD model showed that virtual term neonates maintained a target plasma concentration range within 26 hours when using the dosage regimen recommended on the product label (0.06 mg/kg/h, iv infusion 12 hours), the optimal dose for premature infants to reach the target plasma concentration range may need to be slightly higher than the recommended dose on the product label (0.03mg/kg/h, iv infusion 12h). Conclusion: We successfully established a neonatal PBPK/PD model of midazolam by referring to extrapolated-based research strategy and integrating the influence of human physiological development on drug disposal. Finally, the model was validated with the dosage of midazolam in the product specification, and reliable results were obtained.

show abstract

Dexmedetomidine vs Midazolam for Sedation in Mechanically Ventilated Children: A Randomized Controlled Trial

Cited by 11 publications

References 26 publications

Perioperative dexmedetomidine compared to midazolam in children undergoing open-heart surgery: A pilot randomised controlled trial

Perioperative dexmedetomidine compared to midazolam in children undergoing open-heart surgery: A pilot randomised controlled trial

Effect of dexmedetomidine on hemodynamics in patients undergoing hysterectomy: a meta-analysis and systematic review

Extrapolation of midazolam disposition in neonates using physiological based pharmacokinetic/pharmacodynamic (PBPK/PD) modelling

Contact Info

Product

Resources

About