Evaluation of the effects of dexmedetomidine infusion on oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease

Abstract

BackgroundDexmedetomidine infusion improves oxygenation and lung mechanics in patients with chronic obstructive lung disease; however, its effect in patients with restrictive lung disease has not been thoroughly investigated yet. The aim of this work was to evaluate the effects of dexmedetomidine infusion on oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease.MethodsForty-two morbidly obese patients scheduled for bariatric surgery were included in the study. Patients were randomized to receive either dexmedetomidine infusion at a bolus dose of 1mcg/Kg followed by infusion at 1 mcg/Kg/hour for 90 min (Dexmedetomidine group), or normal saline infusion (Control group). Both groups were compared with regard to: oxygenation {P/F ratio: PaO2/fraction of inspired oxygen (FiO2)}, lung compliance, dead space, plateau pressure, blood pressure, and heart rate.ResultsDexmedetomidine group showed significant improvement of the PaO2/FiO2 ratio, and higher lung compliance compared to control group by the end of drug infusion. Dexmedetomidine group demonstrated decreased dead space, plateau pressure, blood pressure, and heart rate compared to control group by the end of drug infusion.ConclusionA 90-min dexmedetomidine infusion resulted in moderate improvement in oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease.Trial registrationclinicaltrials.gov: NCT02843698 on 20 July 2016.

Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction:a prospective, double-blind, randomized, placebo-controlled trial

“…So, in our study, the lower occurrence of PPCs in DEX group might be in connection with the lessened amount of remifentanil. Seven, Ahmed Hasanin in 2018 44 supposed in his paper that the improvement of lung mechanics might be due to the potential better sedation state of DEX administration to have better relaxation of the chest wall, but this needed further proofs. However, overall speaking, all those above assumptions required further evaluation in more studies with higher level of evidence.…”

Effect of dexmedetomidine on lung function and prognosis a systematic review and meta-analysis

“…After searching the database and comparing the present criteria, a total of 17 trials were included in the meta-analysis (16,19,20,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). These trials are all randomized control trials.…”

“…A total of 461 and 463 patients were included in the dexmedetomidine group and control group, respectively. The type of surgeries was mainly thoracic surgery, others included gastrectomy (28,31) and lower limb surgery (30,32).…”

“…Two trials didn't give enough information about their randomization (19,20). Six trials had the right method of their allocation concealment (16,20,27,29,31,33). Blinding was used in thirteen trials (16, 19, 20, 22, 24-27, 29-31, 33, 34).…”

“…We noticed that dexmedetomidine compared with placebo can signi cant decrease PaCO 2 which indicates that dexmedetomidine can improve pulmonary ventilation. Ahmed et al (31) found that patients using dexmedetomidine showed higher compliance, lower plateau pressure and lower dead space compared with the placebo which leads to better pulmonary ventilation. Zhang et al (22) had the similar conclusion that dexmedetomidine improves pulmonary ventilation through decreasing dead space and improving compliance.…”