Dexmedetomidine, a central and peripheral α2-receptor agonist distinct from GABA receptor for benzodiazepines and propofol, has been approved by the US Food and Drug Administration only for use up to 24 h in mechanically ventilated patients. The investigators aim to compare dexmedetomidine with propofol for sedation \>24h in poly traumatized mechanically ventilated patients.
The importance of optimizing the levels of sedation in critical care has been increasingly recognized. Many intensive care experts are focusing on maintaining a targeted ''ideal'' sedation level according to the individual patient's condition to avoid adverse events such as prolonged mechanical ventilation, respiratory depression, pneumonia, delirium, psychological problems, and increased treatment costs resulting from over sedation. Dexmedetomidine is a selective alpha-2-adrenoceptor agonist. It exerts both sedative and analgesic effects via mechanisms different from other sedatives such as midazolam and propofol, and provides sedation characterized by prompt response to stimuli with no respiratory depression. The investigators aim to compare dexmedetomidine with propofol for sedation \>24h in poly traumatized mechanically ventilated patients. The investigators will perform a prospective, single center trial to investigate the safety and efficacy of dexmedetomidine for long-term sedation in poly traumatized mechanically ventilated ICU patients, in comparison with propofol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Dexmedetomidine sedation at a starting dose of 0.2-7.0 µg/kg/hour.
Propofol sedation at a starting dose of 10-70 µg/kg/hour.
Assiut university hospitals
Asyut, Assiut Governorate, Egypt
percentage of time with in the target sedation range of Richmond Agitation Sedation Scale-3-0
sedation goal is to maintain Richmond Agitation Sedation Scale from -3 up to 0
Time frame: 3 days
serum BUN
Assessment of the serum level of BUN.
Time frame: 3-days
Serum creatinine.
Assessment of the serum level of creatinine.
Time frame: 3-days
Systolic blood pressure
systolic blood pressure is measured every hour for 3- days.
Time frame: 3- days.
diastolic blood pressure
diastolic blood pressure is measured every hour for 3- days.
Time frame: 3- days.
heart rate
heart rate is recorded every hour for 3-days.
Time frame: 3- days.
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