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Dexmedetomidine in renal failure

Hitoshi Yamamura, Yu Kawazoe, Kyohei Miyamoto, Tomonori Yamamoto, Yoshinori Ohta, Takeshi Morimoto
Background: Use of high-dose norepinephrine is thought to have an immunosuppressive action that increases mortality. This study aimed to evaluate the correlation between norepinephrine dosage and prognosis of patients with septic shock. Methods: This study was a nested cohort of the DExmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) trial. We evaluated 112 patients with septic shock and an initial Sequential Organ Failure Assessment Cardiovascular (SOFA-C) category score > 2 and initial lactate level > 2 mmol/L...
2018: Journal of Intensive Care
W Zhong, Y Zhang, M-Z Zhang, X-H Huang, Y Li, R Li, Q-W Liu
WHAT IS KNOWN AND OBJECTIVE: The primary objective of this study was to compare the pharmacokinetics of dexmedetomidine in patients with end-stage renal failure and secondary hyperparathyroidism with those in normal individuals. METHOD: Fifteen patients with end-stage renal failure and secondary hyperparathyroidism (Renal-failure Group) and 8 patients with normal renal and parathyroid gland function (Control Group) received intravenous 0.6 μg/kg dexmedetomidine for 10 minutes before anaesthesia induction...
December 16, 2017: Journal of Clinical Pharmacy and Therapeutics
Wenjia Tong, Conglei Song, Danqun Jin, Jingmin Sun, Yating Wang, Daliang Xu
OBJECTIVE: To compare the sedation and anti-inflammatory effects of dexmedetomidine and midazolam on critical ill children with multiple trauma. METHODS: A prospective randomized controlled trial was conducted. Sixty-five critical ill children with multiple trauma admitted to pediatric intensive care unit (PICU) of Anhui Province Children's Hospital from January 2014 to September 2016 were enrolled, who were randomly divided into dexmedetomidine group (33 cases) and midazolam group (32 cases)...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
E Erkılıç, E Kesimci, F Alaybeyoğlu, I Kılınç, R Tural, A Yazgan, T Gümüş, A Sepici Dinçel, E G Dumlu, O Kanbak
BACKGROUND: Ischemia-reperfusion (I/R) injury is a common cause of patient morbidity and mortality in the perioperative period. Patients undergoing long-lasting, abdominal, and urogenital surgeries with risk factors such as advanced age, peripheral artery disease, diabetes mellitus, renovascular disease, and congestive heart failure are candidates for acute kidney injury (AKI) due to impaired renal perfusion and decreased functional renal reserve. Pharmacological agents with multiple functions and anti-oxidative and anti-inflammation properties may be promising preventative strategies for AKI...
2017: Drug Design, Development and Therapy
Yu Kawazoe, Kyohei Miyamoto, Takeshi Morimoto, Tomonori Yamamoto, Akihiro Fuke, Atsunori Hashimoto, Hiroyuki Koami, Satoru Beppu, Yoichi Katayama, Makoto Itoh, Yoshinori Ohta, Hitoshi Yamamura
Importance: Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. Objectives: To examine whether a sedation strategy with dexmedetomidine can improve clinical outcomes in patients with sepsis undergoing ventilation. Design, Setting, and Participants: Open-label, multicenter randomized clinical trial conducted at 8 intensive care units in Japan from February 2013 until January 2016 among 201 consecutive adult patients with sepsis requiring mechanical ventilation for at least 24 hours...
April 4, 2017: JAMA: the Journal of the American Medical Association
Juhana Honkavaara, Bruno Pypendop, Heta Turunen, Jan Ilkiw
OBJECTIVE: To determine a dose of MK-467, a peripheral α2-adrenoceptor antagonist, which, when administered intravenously (IV) concomitantly with 25 μg kg(-1) of dexmedetomidine, will prevent bradycardia without altering sedation in cats. STUDY DESIGN: Prospective, randomized, controlled, blinded, experimental, crossover study. ANIMALS: Eight healthy, adult, purpose-bred cats. METHODS: Cats were administered seven IV treatments were administered at least 2 weeks apart, consisting of dexmedetomidine 12...
February 22, 2017: Veterinary Anaesthesia and Analgesia
Hao Cheng, Zhongmin Li, Nilas Young, Douglas Boyd, Zane Atkins, Fuhai Ji, Hong Liu
OBJECTIVE: The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. DESIGN: Retrospective investigation. SETTING: Patients from a single tertiary medical center. PARTICIPANTS: A total of 505 patients (≥65 years old) who underwent coronary artery bypass graft (CABG) or valve surgery. CABG and/or valve surgery plus other procedures were divided into 2 groups: 283 received intravenous Dex infusion (Dex group) and 222 did not (Non-Dex group)...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
Juhana Honkavaara, Bruno Pypendop, Heta Turunen, Jan Ilkiw
OBJECTIVE: To determine a dose of MK-467, a peripheral α2 -adrenoceptor antagonist, which, when administered intravenously (IV) concomitantly with 25 μg kg(-1) of dexmedetomidine, will prevent bradycardia without altering sedation in cats. STUDY DESIGN: Prospective, randomized, controlled, blinded, experimental, crossover study. ANIMALS: Eight healthy, adult, purpose-bred cats. METHODS: Cats were administered seven IV treatments were administered at least 2 weeks apart, consisting of dexmedetomidine 12...
May 30, 2016: Veterinary Anaesthesia and Analgesia
Wang Shou-Shi, Song Ting-Ting, Ning Ji-Shun, Chu Hai-Chen
PURPOSE: Oxidative renal injury is the mainstay in patients with spinal cord injury (SCI) and it may eventuate to chronic renal failure. In our study, we investigated the potential of α2-adrenoreceptor agonist Dexmedetomidine (Dex) in ameliorating SCI provoked oxidative renal assault. METHODS: Complete SCI was generated by surgical transaction of the cord at the T10-12 level. Dex administration (50 mcg/kg, b.wt, intraperitoneally) was initiated 12 h after the surgery for 10 days...
August 2015: Renal Failure
Ozan Onur Balkanay, Deniz Goksedef, Suat Nail Omeroglu, Gokhan Ipek
OBJECTIVES: Acute kidney failure after coronary artery bypass grafting (CABG) is a serious complication that increases morbidity and mortality rates. Early detection and prevention of this complication are very important. A novel biomarker named neutrophil gelatinase-associated lipocalin (NGAL) can play an important role in early diagnosis of acute kidney injury. Recent studies on the favourable effects of Dexmedetomidine on cardiac surgery have been published. The aim of this study is to investigate whether there is a dose-dependent positive effect of Dexmedetomidine on neutrophil gelatinase-associated lipocalin levels and renal functions when used after CABG...
February 2015: Interactive Cardiovascular and Thoracic Surgery
Y-N Si, H-G Bao, L Xu, X-L Wang, Y Shen, J-S Wang, X-B Yang
OBJECTIVES: Ischemia/reperfusion (I/R) injury in the kidney during perioperative period remains the leading cause of acute renal failure. The purpose of this experimental study was to determine the role of dexmedetomidine (Dex) on renal I/R injury in rats. MATERIALS AND METHODS: Male Wistar rats, subjected to renal ischemia for 45 min, were either untreated or treated with dexmedetomidine 30 min prior to renal ischemia. A sham-operated group served as the control...
July 2014: European Review for Medical and Pharmacological Sciences
Edip Gonullu, Sevda Ozkardesler, Tuncay Kume, Leyla Seden Duru, Mert Akan, Mehmet Ensari Guneli, Bekir Ugur Ergur, Reci Meseri, Oytun Dora
BACKGROUND AND OBJECTIVES: We investigated the effect of dexmedetomidine on ischemic renal failure in rats. METHODS: In the present study, 26 male adult Wistar albino rats weighting 230-300 g were randomly separated into four groups: sham-operated (n=5), ischemia reperfusion (IR) (IR group, n=7), IR/reperfusion treatment with dexmedetomidine (Dex. R group, n=7) and IR/pre-ischemic treatment with dexmedetomidine (Dex. I group, n=7). In the first group, sham operation was achieved and renal clamps were not applied...
May 2014: Brazilian Journal of Anesthesiology
E Celis-Rodríguez, C Birchenall, M Á de la Cal, G Castorena Arellano, A Hernández, D Ceraso, J C Díaz Cortés, C Dueñas Castell, E J Jimenez, J C Meza, T Muñoz Martínez, J O Sosa García, C Pacheco Tovar, F Pálizas, J M Pardo Oviedo, D I Pinilla, F Raffán-Sanabria, N Raimondi, C Righy Shinotsuka, M Suárez, S Ugarte, S Rubiano
INTRODUCTION: Optimal management of sedation, analgesia and delirium offers comfort and security for the critical care patient, allows support measures to be applied more easily and enables an integral approach of medical care, at the same time that lowers the incidence of complications, wich translates in better patient outcomes. OBJECTIVE: To update the Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo published in Medicina Intensiva in 2007, and give recommendations for the management of sedation, analgesia, and delirium...
November 2013: Medicina Intensiva
Fuhai Ji, Zhongmin Li, Hung Nguyen, Nilas Young, Pengcai Shi, Neal Fleming, Hong Liu
BACKGROUND: Cardiac surgery is associated with a high risk of cardiovascular and other complications that translate into increased mortality and healthcare costs. This retrospective study was designed to determine whether the perioperative use of dexmedetomidine could reduce the incidence of complications and mortality after cardiac surgery. METHODS AND RESULTS: A total of 1134 patients who underwent coronary artery bypass surgery and coronary artery bypass surgery plus valvular or other procedures were included...
April 16, 2013: Circulation
Koichi Nomoto, Corey Scurlock, David Bronster
An 85 year old man with a history of chronic renal insufficiency was admitted to the cardiothoracic intensive care unit after aortic valve replacement. His postoperative course was marked by acute oliguric renal failure for high blood urea nitrogen (BUN) and acute hyperactive delirium. At this time he also developed tremors with muscle twitching; he received no other form of sedatives. A neurology consult made the diagnosis of twitch-convulsive syndrome associated with uremic encephalopathy. While the patient was receiving the dexmedetomidine infusion, the signs of the twitch-convulsive syndrome, particularly the twitching and tremors, disappeared...
December 2011: Journal of Clinical Anesthesia
Takayuki Kunisawa, Satoshi Hanada, Atsushi Kurosawa, Akihiro Suzuki, Osamu Takahata, Hiroshi Iwasaki
We safely administered dexmedetomidine (DEX) for sedation during spinal anesthesia in a very elderly patient. The patient was a 98-year-old woman who had hypertension, renal failure, and first-grade atrioventricular block. She was scheduled to undergo internal fixation for fracture of the femoral neck. Initially, DEX (6.0 μg/kg/h) was administered over 10 min, followed by continuous infusion at a dose of 0.7 μg/kg/h. Consequently, her Ramsay sedation score (RSS) increased to 5, and the patient did not grimace in pain while being turned to the lateral position...
December 2010: Journal of Anesthesia
Katarzyna Rutkowska, Piotr Knapik, Hanna Misiolek
BACKGROUND AND OBJECTIVE: The study investigated the effect of intravenous dexmedetomidine on brachial plexus block in patients with end-stage renal disease sedated with dexmedetomidine or midazolam for the formation of arteriovenous fistula. METHODS: A supraclavicular brachial plexus block was performed in 68 patients scheduled for an arteriovenous fistula formation. A successful block was achieved in 64 patients (94%). Sixty-four patients received either dexmedetomidine (loading dose 1 microg kg 10 min followed by infusion of 0...
October 2009: European Journal of Anaesthesiology
Nivaldo Ribeiro Villela, Paulo do Nascimento Júnior, Lídia Raquel de Carvalho, Andrey Teixeira
BACKGROUND AND OBJECTIVES: Perioperative acute renal failure increases morbidity and mortality. Alpha2-adrenergic agonists used in anesthesia increase urinary output and maintain cardiovascular stability. This study aimed at investigating the effects of dexmedetomidine on renal system and on vasopressin plasma levels in anesthetized dogs. METHODS: This study involved 36 adult mixed-breed dogs anesthetized with propofol, fentanyl, and isoflurane, which were randomly distributed in three groups receiving: G1 -20 mL of 0...
August 2005: Revista Brasileira de Anestesiologia
Hasan Kocoglu, Hulya Ozturk, Hayrettin Ozturk, Fahri Yilmaz, Nebahat Gulcu
Ischemia-reperfusion (I-R) injury remains the leading cause of acute renal failure. The purpose of this experimental study was to determine the role of dexmedetomidine on histologic alterations induced by renal I-R in rats. In the present study, thirty male Sprague-Dawley rats weighing 200-220 g were randomly assigned into three groups: the sham-control group (group 1, n = 10), the R/untreated group (group 2, n = 10), and the I-R/dexmedetomidine-treated group (group 3, n = 10). For group one, we performed a sham operation...
2009: Renal Failure
Marco Aurelio Marangoni, Alex Hausch, Pedro Thadeu Galvão Vianna, José Reinaldo Cerqueira Braz, Rosa Marlene Viero, Yara Marcondes Machado Castiglia
PURPOSE: About 50 % of indications for dialysis in acute renal failure are related to problems originated during the perioperative period. Intraoperative hemodynamic changes lead to renal vasoconstriction and hypoperfusion. Previous studies have not defined the dexmedetomidine renal role in hemorrhage situations. This study evaluated the effect of dexmedetomidine on renal function and histology after acute hemorrhage in rats. METHODS: Covered study with 20 Wistars rats, anesthetized with sodium pentobarbital, 50 mg...
July 2007: Acta Cirúrgica Brasileira
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