Safety of dexmedetomidine for the control of agitation in critically ill traumatic brain injury patients: a descriptive study.
Adult
Age Factors
Aged
Aged, 80 and over
Antipsychotic Agents
/ administration & dosage
Behavioral Symptoms
/ drug therapy
Benzodiazepines
/ administration & dosage
Body Weight
Brain Injuries, Traumatic
/ complications
Comorbidity
Critical Illness
Dexmedetomidine
/ adverse effects
Drug Therapy, Combination
Female
Glasgow Coma Scale
Humans
Hypnotics and Sedatives
/ adverse effects
Intensive Care Units
Male
Middle Aged
Retrospective Studies
Sex Factors
Substance-Related Disorders
/ epidemiology
Trauma Severity Indices
agitation
critical care
dexmedetomidine
traumatic brain injury
Journal
Journal of clinical pharmacy and therapeutics
ISSN: 1365-2710
Titre abrégé: J Clin Pharm Ther
Pays: England
ID NLM: 8704308
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
25
01
2021
received:
09
09
2020
accepted:
08
02
2021
pubmed:
20
2
2021
medline:
15
12
2021
entrez:
19
2
2021
Statut:
ppublish
Résumé
Behavioural disturbances such as agitation are common following traumatic brain injury and can interfere with treatments, cause self-harm and delay rehabilitation. As there is a lack of evidence on the optimal approach to manage agitation in recovering TBI patients, various pharmacological agents are used including antipsychotics, anticonvulsants and sedative agents. Among sedatives, the safety and efficacy of dexmedetomidine to control agitation in traumatic brain injury patients is not well documented. To describe the safety, use and efficacy of dexmedetomidine for the management of agitation following traumatic brain injury in the intensive care unit. Medical records of all patients admitted to the intensive care unit of the Hôpital Sacré-Coeur de Montréal for a traumatic brain injury who received dexmedetomidine for agitation between 1 January 2017 and 31 December 2017 were reviewed. Patients who received dexmedetomidine for indications other than agitation were excluded. Data on dexmedetomidine prescription practices and safety were extracted. Frequency of agitation and concomitant psychoactive medication use was explored over a period starting two days prior to the initiation of dexmedetomidine to six days after or discontinuation, whichever came first. We identified 41 patients in whom dexmedetomidine was initiated. Dexmedetomidine was started on median ICU day 3 (25 Dexmedetomidine use was safe and associated with a reduction in agitation in traumatic brain injury patients in the 96 hours following its initiation.
Sections du résumé
BACKGROUND
BACKGROUND
Behavioural disturbances such as agitation are common following traumatic brain injury and can interfere with treatments, cause self-harm and delay rehabilitation. As there is a lack of evidence on the optimal approach to manage agitation in recovering TBI patients, various pharmacological agents are used including antipsychotics, anticonvulsants and sedative agents. Among sedatives, the safety and efficacy of dexmedetomidine to control agitation in traumatic brain injury patients is not well documented.
OBJECTIVE
OBJECTIVE
To describe the safety, use and efficacy of dexmedetomidine for the management of agitation following traumatic brain injury in the intensive care unit.
METHODS
METHODS
Medical records of all patients admitted to the intensive care unit of the Hôpital Sacré-Coeur de Montréal for a traumatic brain injury who received dexmedetomidine for agitation between 1 January 2017 and 31 December 2017 were reviewed. Patients who received dexmedetomidine for indications other than agitation were excluded. Data on dexmedetomidine prescription practices and safety were extracted. Frequency of agitation and concomitant psychoactive medication use was explored over a period starting two days prior to the initiation of dexmedetomidine to six days after or discontinuation, whichever came first.
RESULTS
RESULTS
We identified 41 patients in whom dexmedetomidine was initiated. Dexmedetomidine was started on median ICU day 3 (25
CONCLUSION
CONCLUSIONS
Dexmedetomidine use was safe and associated with a reduction in agitation in traumatic brain injury patients in the 96 hours following its initiation.
Substances chimiques
Antipsychotic Agents
0
Hypnotics and Sedatives
0
Benzodiazepines
12794-10-4
Dexmedetomidine
67VB76HONO
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1020-1026Informations de copyright
© 2021 John Wiley & Sons Ltd.
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