Dexmedetomidine Improves Cardiovascular and Ventilatory Outcomes in Critically Ill Patients: Basic and Clinical Approaches.
cardiac
dexmedetomidine
non-invasive mechanical ventilation
pharmacokinetics
preconditioning
sedative and analgesic properties
Journal
Frontiers in pharmacology
ISSN: 1663-9812
Titre abrégé: Front Pharmacol
Pays: Switzerland
ID NLM: 101548923
Informations de publication
Date de publication:
2019
2019
Historique:
received:
17
08
2019
accepted:
16
12
2019
entrez:
19
3
2020
pubmed:
19
3
2020
medline:
19
3
2020
Statut:
epublish
Résumé
Dexmedetomidine (DEX) is a highly selective α2-adrenergic agonist with sedative and analgesic properties, with minimal respiratory effects. It is used as a sedative in the intensive care unit and the operating room. The opioid-sparing effect and the absence of respiratory effects make dexmedetomidine an attractive adjuvant drug for anesthesia in obese patients who are at an increased risk for postoperative respiratory complications. The pharmacodynamic effects on the cardiovascular system are known; however the mechanisms that induce cardioprotection are still under study. Regarding the pharmacokinetics properties, this drug is extensively metabolized in the liver by the uridine diphosphate glucuronosyltransferases. It has a relatively high hepatic extraction ratio, and therefore, its metabolism is dependent on liver blood flow. This review shows, from a basic clinical approach, the evidence supporting the use of dexmedetomidine in different settings, from its use in animal models of ischemia-reperfusion, and cardioprotective signaling pathways. In addition, pharmacokinetics and pharmacodynamics studies in obese subjects and the management of patients subjected to mechanical ventilation are described. Moreover, the clinical efficacy of delirium incidence in patients with indication of non-invasive ventilation is shown. Finally, the available evidence from DEX is described by a group of Chilean pharmacologists and clinicians who have worked for more than 10 years on DEX.
Identifiants
pubmed: 32184718
doi: 10.3389/fphar.2019.01641
pmc: PMC7058802
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1641Informations de copyright
Copyright © 2020 Castillo, Ibacache, Cortínez, Carrasco-Pozo, Farías, Carrasco, Vargas-Errázuriz, Ramos, Benavente, Torres and Méndez.
Références
Cochrane Database Syst Rev. 2015 Aug 10;(8):CD011107
pubmed: 26256531
DNA Cell Biol. 2017 Jul;36(7):518-528
pubmed: 28436683
Inflammation. 2014 Oct;37(5):1763-70
pubmed: 24803295
Neurochem Int. 2009 Dec;55(7):593-600
pubmed: 19501623
Br J Anaesth. 1997 Apr;78(4):400-6
pubmed: 9135361
Cardiovasc Hematol Disord Drug Targets. 2015;15(1):57-69
pubmed: 25567335
Can J Anaesth. 2005 Feb;52(2):176-80
pubmed: 15684259
J Diabetes Res. 2018 Oct 8;2018:3071959
pubmed: 30402501
Int J Clin Pharmacol Ther. 2016 Mar;54(3):200-7
pubmed: 26857784
Anesthesiology. 1993 May;78(5):813-20
pubmed: 8098190
Eur J Clin Pharmacol. 2012 Jun;68(6):937-42
pubmed: 22271297
Life Sci. 2016 Jan 1;144:162-9
pubmed: 26655164
Crit Care Med. 2013 Jan;41(1):263-306
pubmed: 23269131
Anaesth Intensive Care. 2004 Dec;32(6):741-5
pubmed: 15648981
Crit Care. 2011;15(5):R257
pubmed: 22030215
Anesthesiology. 2003 Jul;99(1):65-70
pubmed: 12826844
Eur J Clin Pharmacol. 2015 Dec;71(12):1501-8
pubmed: 26407689
PLoS One. 2011;6(5):e20220
pubmed: 21637849
N Engl J Med. 2014 Apr 24;370(17):1626-35
pubmed: 24758618
Anesthesiology. 2008 Jan;108(1):94-102
pubmed: 18156887
Mol Med Rep. 2017 Jan;15(1):131-138
pubmed: 27959438
Br J Anaesth. 2009 Aug;103(2):268-74
pubmed: 19541679
Crit Care. 2016 May 05;20(1):128
pubmed: 27145814
Rev Bras Anestesiol. 2005 Oct;55(5):525-31
pubmed: 19468643
Rom J Anaesth Intensive Care. 2018 Apr;25(1):73-81
pubmed: 29756066
Sao Paulo Med J. 2004 Jan 8;122(1):8-11
pubmed: 15160520
N Engl J Med. 2019 Jun 27;380(26):2506-2517
pubmed: 31112380
Anesthesiology. 2000 Aug;93(2):382-94
pubmed: 10910487
Curr Neurol Neurosci Rep. 2018 Aug 6;18(10):64
pubmed: 30083844
Anaesthesia. 1999 Dec;54(12):1136-42
pubmed: 10594409
Paediatr Drugs. 2008;10(1):49-69
pubmed: 18162008
J Clin Pharm Ther. 2012 Dec;37(6):698-703
pubmed: 22650799
J Clin Neurosci. 2005 May;12(4):375-8
pubmed: 15925765
Eur J Drug Metab Pharmacokinet. 2017 Apr;42(2):201-211
pubmed: 27037817
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Sep;29(9):857-860
pubmed: 28936967
Br J Anaesth. 2008 Sep;101(3):395-9
pubmed: 18567675
JBI Database System Rev Implement Rep. 2016 Jan 15;13(12):287-313
pubmed: 26767820
Ann Transl Med. 2018 Sep;6(18):355
pubmed: 30370282
J Neurochem. 2008 Jul;106(2):519-28
pubmed: 18384648
Crit Care Med. 2018 Sep;46(9):e825-e873
pubmed: 30113379
Int J Antimicrob Agents. 2017 Feb;49(2):204-211
pubmed: 28038961
J Cell Biochem. 2017 Sep;118(9):2635-2644
pubmed: 27987330
Gut. 2000 Aug;47(2):242-50
pubmed: 10896916
J Crit Care. 2009 Dec;24(4):568-74
pubmed: 19682844
Eur J Clin Pharmacol. 2011 Aug;67(8):825-31
pubmed: 21318594
Crit Care. 2000;4(5):302-8
pubmed: 11056756
Paediatr Anaesth. 2013 Feb;23(2):170-9
pubmed: 23043461
Qual Health Res. 2012 Feb;22(2):157-73
pubmed: 21908706
Medicine (Baltimore). 2018 Oct;97(41):e12573
pubmed: 30313043
Curr Drug Targets. 2009 Aug;10(8):687-95
pubmed: 19702517
Anesth Analg. 2008 Jan;106(1):114-9, table of contents
pubmed: 18165564
Cochrane Database Syst Rev. 2017 Jul 13;7:CD004104
pubmed: 28702957
Biochem J. 1991 Dec 15;280 ( Pt 3):561-73
pubmed: 1837214
Int J Cardiol. 2018 Nov 15;271:256-257
pubmed: 29954669
Brain Res. 2013 Feb 4;1494:1-8
pubmed: 23219579
Br J Anaesth. 2015 Aug;115(2):171-82
pubmed: 26170346
Anesth Essays Res. 2011 Jul-Dec;5(2):128-33
pubmed: 25885374
Anesthesiology. 2010 Feb;112(2):453-61
pubmed: 20068454
Asian Pac J Trop Med. 2015 Oct;8(10):836-40
pubmed: 26522299
Br J Anaesth. 2000 Jul;85(1):91-108
pubmed: 10927998
J Neuroimmune Pharmacol. 2016 Jun;11(2):238-47
pubmed: 26932203
Chest. 2007 Aug;132(2):624-36
pubmed: 17699134
J Anesth. 2016 Oct;30(5):763-9
pubmed: 27312979
Acta Anaesthesiol Scand. 2011 Mar;55(3):359-67
pubmed: 21288220
Anesthesiology. 2015 Aug;123(2):357-67
pubmed: 26068206
Intensive Care Med. 2017 Feb;43(2):155-170
pubmed: 27734109
Neuroscience. 2009 Mar 3;159(1):127-35
pubmed: 19010396
Neuroscience. 2010 Nov 10;170(4):1028-34
pubmed: 20732391
Anesthesiology. 2008 Mar;108(3):457-66
pubmed: 18292683
Ann Pharmacother. 2013 Jun;47(6):869-76
pubmed: 23719785
Paediatr Anaesth. 2007 May;17(5):438-44
pubmed: 17474950
J Intensive Care Med. 2019 Jan;34(1):62-66
pubmed: 28122469
Acta Anaesthesiol Scand. 2005 Sep;49(8):1088-91
pubmed: 16095449
JAMA. 2004 Apr 14;291(14):1753-62
pubmed: 15082703
Anesth Analg. 2010 Aug;111(2):490-5
pubmed: 20610555
Paediatr Anaesth. 2009 Nov;19(11):1119-29
pubmed: 19708909
Intensive Care Med. 2015 Sep;41(9):1688-91
pubmed: 26149300
Semin Respir Crit Care Med. 2015 Dec;36(6):899-913
pubmed: 26595050
Can J Anaesth. 2015 Jul;62(7):816-29
pubmed: 25851018
Br J Clin Pharmacol. 1991 Feb;31(2):160-5
pubmed: 1675577
Annu Rev Genet. 2009;43:95-118
pubmed: 19659442
Anesth Analg. 2003 Mar;96(3):657-64, table of contents
pubmed: 12598239
Lancet. 2016 Oct 15;388(10054):1893-1902
pubmed: 27542303
Trends Neurosci. 1999 Jun;22(6):257-63
pubmed: 10354603
Anesth Analg. 2010 May 1;110(5):1383-92
pubmed: 20418300
Microvasc Res. 2019 May;123:1-6
pubmed: 30179598
Crit Care Med. 2004 Jun;32(6):1322-6
pubmed: 15187514
J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):341-346
pubmed: 30386017
J Mol Cell Cardiol. 2009 Jun;46(6):821-31
pubmed: 19265700
Cochrane Database Syst Rev. 2009 Oct 07;(4):CD004126
pubmed: 19821319
Cell Signal. 2008 Jan;20(1):21-30
pubmed: 17716864
Anaesth Crit Care Pain Med. 2016 Feb;35(1):7-15
pubmed: 26700947
Clin Exp Pharmacol Physiol. 2015 Aug;42(8):828-36
pubmed: 26016707
Anesthesiology. 2005 Aug;103(2):269-73
pubmed: 16052108
Am J Respir Crit Care Med. 2001 Mar;163(4):874-80
pubmed: 11282759
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2013 May;42(3):326-30
pubmed: 23801622
Free Radic Biol Med. 2017 May;106:345-354
pubmed: 28216385
Paediatr Anaesth. 2008 May;18(5):403-11
pubmed: 18363626
Sleep. 2014 May 01;37(5):871-80
pubmed: 24790265
Anesthesiology. 2000 Nov;93(5):1345-9
pubmed: 11046225
Am J Respir Crit Care Med. 2018 May 1;197(9):1147-1156
pubmed: 29498534
Curr Opin Crit Care. 2008 Aug;14(4):403-7
pubmed: 18614903
Am J Physiol Lung Cell Mol Physiol. 2014 Mar 15;306(6):L497-507
pubmed: 24414256
J Mol Cell Cardiol. 2001 Jun;33(6):1065-89
pubmed: 11444914
Br J Anaesth. 2002 May;88(5):669-75
pubmed: 12067004
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Feb 20;37(2):150-156
pubmed: 28219856
J Crit Care. 2020 Apr;56:140-144
pubmed: 31901649
Drugs. 2000 Feb;59(2):263-8; discussion 269-70
pubmed: 10730549
JAMA. 2012 Mar 21;307(11):1195-7
pubmed: 22436960
Hypertension. 2008 Feb;51(2):406-11
pubmed: 18071056
Arch Biochem Biophys. 1979 Jul;195(2):453-9
pubmed: 383019
Cell Signal. 2006 May;18(5):729-39
pubmed: 16098714
J Neurosurg Anesthesiol. 2004 Apr;16(2):126-35
pubmed: 15021281
JAMA. 2009 Feb 4;301(5):489-99
pubmed: 19188334
Am J Crit Care. 2017 Jul;26(4):288-296
pubmed: 28668914
Med Sci Monit. 2014 Dec 18;20:2714-9
pubmed: 25529851
Clin Exp Pharmacol Physiol. 2009 Apr;36(4):406-12
pubmed: 19018801
Ann Intensive Care. 2018 Sep 20;8(1):92
pubmed: 30238227
Anesthesiology. 2004 Nov;101(5):1066-76
pubmed: 15505441
Clin Drug Investig. 2013 Aug;33(8):579-87
pubmed: 23839483
Crit Care Med. 2019 Feb;47(2):e89-e95
pubmed: 30394918
J Stroke Cerebrovasc Dis. 2019 May;28(5):1281-1289
pubmed: 30797643
Anesth Analg. 2008 Oct;107(4):1340-7
pubmed: 18806050
Clin Drug Investig. 2018 Jun;38(6):535-543
pubmed: 29502195
Inflamm Res. 2017 May;66(5):399-411
pubmed: 28224201
Anesth Analg. 2006 Jul;103(1):52-6, table of contents
pubmed: 16790625
Anaesthesia. 2008 Jan;63(1):4-14
pubmed: 18086064
Eur J Clin Pharmacol. 2015 Oct;71(10):1197-207
pubmed: 26233335
J Cardiothorac Vasc Anesth. 2011 Apr;25(2):233-7
pubmed: 20709569
Anesthesiol Clin. 2017 Jun;35(2):233-245
pubmed: 28526145
Clin Pharmacokinet. 2017 Aug;56(8):893-913
pubmed: 28105598
Medicine (Baltimore). 2018 Sep;97(39):e12140
pubmed: 30278489
Br J Anaesth. 2012 Mar;108(3):460-8
pubmed: 22277665
Anaesthesia. 2014 Nov;69(11):1214-21
pubmed: 24915800
Crit Care Med. 2013 Sep;41(9 Suppl 1):S30-8
pubmed: 23989093
Anesthesiology. 2010 Feb;112(2):373-83
pubmed: 20098140
Neurotoxicol Teratol. 2017 Mar - Apr;60:102-116
pubmed: 28065636
Paediatr Anaesth. 2010 May;20(5):425-33
pubmed: 20337956
Saudi J Anaesth. 2011 Jan;5(1):36-41
pubmed: 21655014
Br J Pharmacol. 2001 Nov;134(5):957-68
pubmed: 11682443
N Engl J Med. 2014 Jan 30;370(5):444-54
pubmed: 24476433
Pain. 2013 Jul;154(7):1140-9
pubmed: 23706726
Pain. 2006 Jun;122(3):245-57
pubmed: 16530964
Clin Drug Investig. 2012 Aug 1;32(8):561-7
pubmed: 22741747
Br J Anaesth. 1999 Sep;83(3):372-80
pubmed: 10655905
Exp Ther Med. 2017 May;13(5):2355-2361
pubmed: 28565849
J Anesth. 2014 Feb;28(1):38-50
pubmed: 23912755
Mol Med Rep. 2018 May;17(5):7258-7264
pubmed: 29568958
Free Radic Res. 2011 Feb;45(2):156-64
pubmed: 20942566
Anesthesiology. 1998 Sep;89(3):574-84
pubmed: 9743392
Ann Fr Anesth Reanim. 2008 Jul-Aug;27(7-8):574-80
pubmed: 18614329
J Cardiothorac Vasc Anesth. 2014 Dec;28(6):1459-66
pubmed: 25034724
J Pharmacokinet Pharmacodyn. 2016 Jun;43(3):315-24
pubmed: 27221375
J Clin Anesth. 2007 Mar;19(2):141-4
pubmed: 17379129
Int J Mol Med. 2018 Apr;41(4):2328-2338
pubmed: 29328437
Pharmacol Res. 2016 Jan;103:318-27
pubmed: 26607864
Br J Anaesth. 1996 Sep;77(3):427-9
pubmed: 8949826
Anesth Analg. 2019 Dec;129(6):1653-1665
pubmed: 31743187
Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2013 Jul;29(4):316-7
pubmed: 24175551
Curr Opin Anaesthesiol. 2017 Aug;30(4):441-451
pubmed: 28537937
Exp Ther Med. 2018 Feb;15(2):2037-2043
pubmed: 29434802
Acta Anaesthesiol Scand. 2006 Feb;50(2):222-7
pubmed: 16430546
Biochim Biophys Acta. 2012 Apr;1822(4):537-45
pubmed: 22230708
J Clin Anesth. 2017 Aug;40:25-32
pubmed: 28625441
Cell Physiol Biochem. 2017;42(5):1907-1919
pubmed: 28873369
Nat Med. 2008 Apr;14(4):442-7
pubmed: 18345011
Resuscitation. 2007 Sep;74(3):538-45
pubmed: 17391832
J Pharm Sci. 2000 Apr;89(4):519-27
pubmed: 10737913
Br J Clin Pharmacol. 2003 Dec;56(6):691-3
pubmed: 14616431
Clin Pharmacol Ther. 2002 Mar;71(3):115-21
pubmed: 11907485
J Neurosurg Anesthesiol. 2013 Jan;25(1):16-24
pubmed: 22824921
Br J Anaesth. 2018 Aug;121(2):384-397
pubmed: 30032877
BMC Anesthesiol. 2018 Jan 5;18(1):3
pubmed: 29304735
Lancet. 2014 Mar 8;383(9920):911-22
pubmed: 23992774
Metab Brain Dis. 2017 Apr;32(2):539-546
pubmed: 28035625
Am J Physiol Renal Physiol. 2002 May;282(5):F943-52
pubmed: 11934705
Biomed Res. 2008 Aug;29(4):189-94
pubmed: 18724006
Anesth Analg. 2016 May;122(5):1556-66
pubmed: 26218862
PLoS One. 2018 Nov 14;13(11):e0207427
pubmed: 30427948
Anesth Analg. 2011 Nov;113(5):1129-42
pubmed: 21821507
Arch Med Sci. 2014 Feb 24;10(1):19-24
pubmed: 24701209
Paediatr Anaesth. 2013 Feb;23(2):134-8
pubmed: 22985207
Dig Dis Sci. 2018 Jun;63(6):1633-1640
pubmed: 29594976
J Clin Anesth. 2015 Dec;27(8):632-7
pubmed: 26277872
Br J Anaesth. 2018 May;120(5):969-977
pubmed: 29661414
Acta Cir Bras. 2011 Jun;26(3):202-6
pubmed: 21537522
Am J Med. 2003 Jun 15;114(9):742-52
pubmed: 12829201
Exp Neurol. 2009 Aug;218(2):333-46
pubmed: 19272377
Anesthesiology. 2006 Dec;105(6):1098-110
pubmed: 17122572
Eur J Anaesthesiol. 2010 Mar;27(3):280-4
pubmed: 19935071
J Surg Res. 2012 Nov;178(1):424-30
pubmed: 22445456
Crit Care Clin. 2009 Jul;25(3):451-69, vii
pubmed: 19576524
J Trauma Acute Care Surg. 2013 May;74(5):1370-5
pubmed: 23609293
Anesthesiology. 2006 Nov;105(5):902-10; quiz 1069-70
pubmed: 17065883
Q Rev Biol. 2012 Jun;87(2):89-127
pubmed: 22696939