Effect of Dexmedetomidine -based early goal-oriented sedation strategy on gastrointestinal function in patients with sepsis

Abstract

Objective To investigate the effect of early goal-oriented sedation strategy on gastrointestinal function in sepsis patients with different sedatives. Methods A randomized controlled study was conducted on patients with sepsis who were admitted to ICU of Zhuji Hospital of Traditional Chinese Medicine consecutively from January 2017 to February 2019. Sepsis patients were randomly divided into three groups: Dex group (n=31), Mid group (n=30) and Pro group (n=32). All three groups of patients adopted early goal-directed sedation (EGDS) based on the sufficient analgesia of butorphanol tartrate. Dex group was sedated with Dexmedetomidine, Mid group with Midazolam, Pro group with Propofol. Gastrointestinal indexes (DAO, IFABP and AGI grading) at day 1 (T1), day 3 (T3) and day 7 (T7) were recorded in the three groups. Average daily dose of analgesics, daily costs of sedation and analgesia during hospitalization, mechanical ventilation time, length of ICU stay, vasoactive drug usage, and delirium incidence were also recorded. Results (1) gastrointestinal injury indexes: Dex group was significantly lower than Mid group and Pro group, and the differences in the interaction between the indexes, time points and between groups were statistically significant (P 0.05). (2) AGI grading: Dex group was significantly lower than Mid group and Pro group, and the difference was statistically significant (P 0.05). Conclusion The sedative and analgesic regimen of Dexmedetomidine combined with Butorphanol tartrate can improve the gastrointestinal function of patients with acute gastrointestinal injury caused by sepsis, reduce AGI grading, reduce mechanical ventilation time and reduce the incidence of delirium. Key words: Sepsis; Acute gastrointestinal injury; Dexmedetomidine; Butorphanol tartrate; Early goal-directed sedation