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| Clinical study of early goal-directed sedation in mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease |
| WANG Hongzhou DENG Lijuan▲ TANG Qin CHENG Senzhong |
| Department of Intensive Care Unit, Sichuan Mianyang 404th Hospital, Sichuan Province, Mianyang 621000, China |
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Abstract Objective To study the clinical application of early goal-directed sedation in mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 90 patients with AECOPD given mechanical ventilation from July 2015 to May 2017 in Intensive Care Unit of Sichuan Mianyang 404th Hospital were randomly divided into control group (standard sedation regimen) and observation group (Dexmedetomidine early goal-directed sedation), 45 cases in each group. Sedation target was RASS -2 to 1 points. The first dose of load and maintenance doses were carried out according to the instructions. The reaching ideal sedation time, wake-up time, ICU hospitalization time, duration of mechanical ventilation, adverse reactions and levels of inflammatory cytokine were compared between the two groups. Results There was no significant difference between the two groups in reaching ideal sedation time (P > 0.05), but the wake-up time of the observation group was significantly shorter than the control group (P < 0.05). There was no significant difference between the two groups in ICU hospitalization time (P > 0.05), but the duration of mechanical ventilation of the observation group was significantly shorter than the control group (P < 0.05). The adverse reactions of the observation group were lower than those of the control group (P < 0.05). There was no statistically significant difference in plasma TNF-α level between the two groups when they were stabilized by 24 h (P > 0.05), however, the level of plasma IL-1 in the observation group was lower than that of the control group at the stabilization of 24 h (P < 0.05). Conclusion It is feasible to perform early goal-directed sedation in mechanical ventilation AECOPD patients with satisfactory sedative effect, which can shorten the duration of ICU hospitalization and reduce the adverse reactions.
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