Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery
Purpose. The aim of this retrospective study was to assess the haemodynamic adverse effects of clonidine and dexmedetomidine in critically ill patients after cardiac surgery. Methods. 2769 patients were screened during the 30-month study period. Heart rate (HR), mean arterial pressure (MAP), and nor...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/4750615 |
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| author | Angelina Grest Judith Kurmann Markus Müller Victor Jeger Bernard Krüger Donat R. Spahn Dominique Bettex Alain Rudiger |
| author_facet | Angelina Grest Judith Kurmann Markus Müller Victor Jeger Bernard Krüger Donat R. Spahn Dominique Bettex Alain Rudiger |
| author_sort | Angelina Grest |
| collection | DOAJ |
| description | Purpose. The aim of this retrospective study was to assess the haemodynamic adverse effects of clonidine and dexmedetomidine in critically ill patients after cardiac surgery. Methods. 2769 patients were screened during the 30-month study period. Heart rate (HR), mean arterial pressure (MAP), and norepinephrine requirements were assessed 3-hourly during the first 12 hours of the continuous drug infusion. Results are given as median (interquartile range) or numbers (percentages). Results. Patients receiving clonidine (n = 193) were younger (66 (57–73) vs 70 (63–77) years, p=0.003) and had a lower SAPS II (35 (27–48) vs 41 (31–54), p=0.008) compared with patients receiving dexmedetomidine (n = 141). At the start of the drug infusion, HR (90 (75–100) vs 90 (80–105) bpm, p=0.028), MAP (70 (65–80) vs 70 (65–75) mmHg, p=0.093), and norepinephrine (0.05 (0.00–0.11) vs 0.12 (0.03–0.19) mcg/kg/min, p<0.001) were recorded in patients with clonidine and dexmedetomidine. Bradycardia (HR < 60 bpm) developed in 7.8% with clonidine and 5.7% with dexmedetomidine (p=0.51). Between baseline and 12 hours, norepinephrine remained stable in the clonidine group (0.00 (−0.04–0.02) mcg/kg/min) and decreased in the dexmedetomidine group (−0.03 (−0.10–0.02) mcg/kg/min, p=0.007). Conclusions. Dexmedetomidine and the low-cost drug clonidine can both be used safely in selected patients after cardiac surgery. |
| format | Article |
| id | doaj-art-2e5d074d6f4f40439eb18b512de4e075 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-2e5d074d6f4f40439eb18b512de4e0752025-02-03T01:30:30ZengWileyCritical Care Research and Practice2090-13052090-13132020-01-01202010.1155/2020/47506154750615Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac SurgeryAngelina Grest0Judith Kurmann1Markus Müller2Victor Jeger3Bernard Krüger4Donat R. Spahn5Dominique Bettex6Alain Rudiger7Institute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandInstitute for Anaesthesiology, University Zurich and University Hospital Zurich, Zürich, SwitzerlandPurpose. The aim of this retrospective study was to assess the haemodynamic adverse effects of clonidine and dexmedetomidine in critically ill patients after cardiac surgery. Methods. 2769 patients were screened during the 30-month study period. Heart rate (HR), mean arterial pressure (MAP), and norepinephrine requirements were assessed 3-hourly during the first 12 hours of the continuous drug infusion. Results are given as median (interquartile range) or numbers (percentages). Results. Patients receiving clonidine (n = 193) were younger (66 (57–73) vs 70 (63–77) years, p=0.003) and had a lower SAPS II (35 (27–48) vs 41 (31–54), p=0.008) compared with patients receiving dexmedetomidine (n = 141). At the start of the drug infusion, HR (90 (75–100) vs 90 (80–105) bpm, p=0.028), MAP (70 (65–80) vs 70 (65–75) mmHg, p=0.093), and norepinephrine (0.05 (0.00–0.11) vs 0.12 (0.03–0.19) mcg/kg/min, p<0.001) were recorded in patients with clonidine and dexmedetomidine. Bradycardia (HR < 60 bpm) developed in 7.8% with clonidine and 5.7% with dexmedetomidine (p=0.51). Between baseline and 12 hours, norepinephrine remained stable in the clonidine group (0.00 (−0.04–0.02) mcg/kg/min) and decreased in the dexmedetomidine group (−0.03 (−0.10–0.02) mcg/kg/min, p=0.007). Conclusions. Dexmedetomidine and the low-cost drug clonidine can both be used safely in selected patients after cardiac surgery.http://dx.doi.org/10.1155/2020/4750615 |
| spellingShingle | Angelina Grest Judith Kurmann Markus Müller Victor Jeger Bernard Krüger Donat R. Spahn Dominique Bettex Alain Rudiger Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery Critical Care Research and Practice |
| title | Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery |
| title_full | Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery |
| title_fullStr | Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery |
| title_full_unstemmed | Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery |
| title_short | Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery |
| title_sort | cardiovascular safety of clonidine and dexmedetomidine in critically ill patients after cardiac surgery |
| url | http://dx.doi.org/10.1155/2020/4750615 |
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