Navigation Links
Newer Sedative Might Help Patients on Ventilators
Date:12/11/2007

Preliminary study finds dexmedetomidine caused less delirium,,,,

TUESDAY, Dec. 11 (HealthDay News) -- Doctors routinely use sedatives on patients who are hooked up to mechanical ventilators in intensive care units, but some experts worry that too much sedation might slow down recovery and leave patients in an unnecessary fog.

Now, researchers report that by substituting a newer medication, dexmedetomidine (Precedex), for the more commonly used lorazepam (Ativan), doctors could reduce the amount of time patients experience delirium and coma. They also found a reduction in the length of time on mechanical ventilation and an improvement in survival, though these differences didn't reach the level of statistical significance.

"By changing the way we give medications, we may be able to improve outcomes," said study author Dr. Pratik Pandharipande, from the anesthesiology and critical care department at Vanderbilt University Medical Center in Nashville, Tenn. His report is published in the Dec. 12 issue of the Journal of the American Medical Association.

"By incorporating this sedative, patients had four more days alive without delirium or coma. They also had greater time off the mechanical ventilator and had shorter ICU stays. And, there was an important trend toward decreased mortality, about a 10 percent reduction in mortality," he said.

However, not everyone is convinced that the newer sedative is a significant improvement.

"This study reminds me of the importance in minimizing sedation. The principles of this study make sense to me, but the study is flawed. They started using 10 milligrams per hour of lorazepam, and it's a dose we don't use. It's a rarity to use a dose that high," said Dr. Kevin Grady, interim chief medical officer for St. John's Health System and director of pulmonary and critical care at St. John Hospital and Medical Center in Detroit. Grady said a more standard dose of lorazepam is 2 to 4 milligrams per hour.

"This just doesn't prove to me that dexmedetomidine is better than lorazepam," added Grady.

The current study included 106 people hospitalized in the ICU and on mechanical ventilators. They were randomly assigned to receive sedation either with dexmedetomidine or with lorazepam. The sedation period varied but lasted as long as 120 hours.

While the manufacturer of dexmedetomidine, Hospira, provided an unrestricted grant and the study medication to the researchers, the company had no input in the study's design, conduct or analysis, according to the authors.

The researchers found that sedation with dexmedetomidine reduced the number of days that patients experienced delirium or coma by an average of four days. The prevalence of coma was 92 percent for those on lorazepam and 63 percent for those on dexmedetomidine.

The 28-day mortality rate was 27 percent for the lorazepam group versus 17 percent for those on dexmedetomidine.

According to Pandharipande, although the initial cost of dexmedetomidine might be higher than that of lorazepam, the improved outcomes offset that cost.

Because the study size was small, Pandharipande said more research needs to be done to confirm these findings, but that this study offered "proof of concept."

"We do have an alternate sedation strategy to reduce the burden of brain dysfunction," said Pandharipande.

Grady said there are certain patients who may benefit more from the use of dexmedetomidine, such as those going through alcohol withdrawal. But, until further studies are done, Grady added, "I'm hard-pressed to think it's worth the expense. This drug costs twice as much as lorazepam."

More information

Read more about lorazepam and its potential side effects at the U.S. National Library of Medicine.



SOURCES: Pratik Pandharipande, M.D., department of anesthesiology and critical care, Vanderbilt University Medical Center, Nashville, Tenn.; Kevin Grady, M.D., director, pulmonary and critical care, St. John Hospital and Medical Center, and interim chief medical officer, St. John's Health System; Dec. 12, 2007, Journal of the American Medical Association


'/>"/>
Copyright©2007 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Newer antidepressants led to less, not more, teen suicides
2. Newer Antibiotic Speeds TB Healing
3. Newer radiation treatment easier for some throat cancer patients
4. Newer Anticlotting Drug Safe, Effective for Heart Surgeries
5. Fish Oil Might Help Relieve MS
6. HIV Drug Might Fight Cancer
7. High and mighty: first common height gene identified by researchers behind obesity gene finding
8. Vitamin C Plus Fat Might Spur Cancer
9. Mathematics might save you a trip to the ER
10. Veggies Might Ward Off Age-Linked Vision Woes
11. Rating your pain from 0 to 10 might not help your doctor
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Newer Sedative Might Help Patients on Ventilators
(Date:6/24/2016)... ... ... Marcy was in a crisis. Her son James, eight, was out of control. Prone to ... , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there ... my other children and say he was going to kill them. If we were ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced that ... chosen by their peers for this recognition are considered among the top 2 percent ... special honors as members of this year’s Legal Elite Hall of Fame: Miami ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, ... and the Road To Recovery® program to drive cancer patients to and from their ... to ensure the highest quality of life and ongoing independence. Getting to and ...
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are sharpening their pencils ... an essay contest in which patients and their families pay tribute to a genetic ... 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. ...
(Date:6/24/2016)... York, NY (PRWEB) , ... June 24, 2016 ... ... publication Haute Living, is proud to recognize Dr. Barry M. Weintraub as a ... that “the most beautiful women in the world, and the most handsome men, ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Research ... MEMS Devices Medical Market Analysis 2016 - Forecast to 2022" ... The report contains up to date financial data ... analysis. Assessment of major trends with potential impact on the ... analysis of market segmentation which comprises of sub markets, regional ...
(Date:6/23/2016)... , June 23, 2016 , ... on Thursday, July 7, 2016 , , , , LOCATION: ... , , , , EXPERT PANELISTS:  , , , ... Senior Industry Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar and ... The global pharmaceutical industry is witnessing an exceptional era. ...
(Date:6/23/2016)...  Guerbet announced today that it has been named ... . One of 12 suppliers to receive ... support of Premier members through exceptional local customer service ... to lower costs. ... outstanding customer service from Premier," says Massimo Carrara ...
Breaking Medicine Technology: