Abstract P-499: EFFECTS OF TWO DIFFERENT SEDATION REGIMENS ON SEDATION AND INFLAMMATORY RESPONSE IN CRITICALLY ILL CHILDREN WITH MULTIPLE TRAUMAS

Abstract

Aims & Objectives: To compare the efficacy and anti-inflammatory effects of dexmedetomidine and midazolam of critical ill children with multiple trauma. Methods A prospective randomized controlled trial was conducted.Critical ill children with multiple trauma admitted to PICU of Anhui Province Children’s Hospital who were randomly generated by computer and divided into dexmedetomidine group and midazolam group. Children of two groups both received sufentanil for analgesia.The goal of sedation was to maintain RASS score of -1 to 0. The level of IL-6, IL-8, IL-10, IL-1β),TNF-α and CRP detected by ELISA at 24, 48, 72 hours after treatment, and the duration of mechanical ventilation, ratio of CRRT, length of stay in the PICU, ratio of sepsis and MOF and mortality were also recorded. Results Compared with midazolam, dexmedetomidine decreased the level of pro-inflammatory cytokines and increased the level of anti-inflammatory cytokines. At 24 hours after treatment, the levels of serum IL-1β, TNF-α significantly decreased and IL-10 significantly increased. At 48 hours after treatment, the levels of serum IL-6, IL-8, IL-1β, TNF-α and CRP significantly decreased and IL-10 significantly increased. At 72 hours after treatment, only the levels of serum IL-8 and CRP significantly decreased. Compared with midazolam, dexmedetomidine could significantly reduce the duration of mechanical ventilation, length of PICU stay, the ratio of sepsis.But there were no significant differences in ratio of CRRT and MOF and mortality between two groups. Conclusions Compared with midazolam, dexmedetomidine had better efficacy in the treatment of severe multiple trauma in children and reduce the level of inflammation.