期刊
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
卷 28, 期 2, 页码 267-273出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.jvca.2013.06.022
关键词
coronary artery bypass graft; dexmedetomidine; outcomes; delirium; mortality
资金
- University of California Davis Health System Department of Anesthesiology and Pain Medicine, Department of Surgery
- Department of Internal Medicine
- NIH [UL1 TR000002]
- Jiangsu Province's by Key Provincial Talents Program, China
- Jiangsu province's six major peak talents program, China
- Suzhou science from Technology Bureau's program, China [SYS201111]
Objective: This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery. Design: Retrospective investigation. Setting: Patients from a single tertiary medical center. Participants: A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX). Interventions: Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 mu g/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit. Measurements and Main Results: Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5% and 4.0% (adjusted odds ratio [OR], 0.332; 95% CI, 0.155 to 0.708; p = 0.0044), 2.0% and 4.5% (adjusted OR, 0.487; 95% CI, 0.253 to 0.985; p = 0.0305), and 3.2% and 6.9% (adjusted OR 0.421; 95% CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9% to 4.6% (adjusted OR, 0.431; 95% CI, 0.265-0.701; p = 0.0007). Conclusion: Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium. (C) 2014 Elsevier Inc. All rights reserved.
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