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Efficacy and Safety of Dexmedetomidine in the Prone Position in Elderly Patients with Pneumonia: A Prospective, Double-Blind, Randomized Controlled Study
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Efficacy and Safety of Dexmedetomidine in the Prone Position in Elderly Patients with Pneumonia: A Prospective, Double-Blind, Randomized Controlled Study
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Efficacy and Safety of Dexmedetomidine in the Prone Position in Elderly Patients with Pneumonia: A Prospective, Double-Blind, Randomized Controlled Study
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Journal Article
Efficacy and Safety of Dexmedetomidine in the Prone Position in Elderly Patients with Pneumonia: A Prospective, Double-Blind, Randomized Controlled Study
2024
Overview
Purpose
We aimed to identify a safe and effective method to assist older adults with pneumonia in tolerating the prone position for a longer duration.
Methods
This was a randomized, controlled, double-blinded study performed at the Shanghai Fourth People's Hospital. Eighty patients with pneumonia aged ≥ 65 years were included. The patients were able to spontaneous breath in the prone position and were administered intravenous dexmedetomidine or an isotonic sodium chloride solution. The cumulative daily durations of prone positioning for all patients in the two groups were recorded. The primary outcome was the percentage of patients who completed ≥ 9 h/day in the prone position. The secondary outcomes included the incidence of complications in the prone position and patient outcomes.
Results
Eighty patients were included (average age: 79.6 ± 8.9 years). The percentage of patients who completed ≥ 9 h/day in the prone position was significantly higher in the dexmedetomidine group than in the placebo group (
P
= 0.011). The percentage of patients who completed ≥ 12 h/day in the prone position was also significantly greater in the dexmedetomidine group than in the placebo group (
P
= 0.008). There were no significant differences in other variables between the two groups.
Conclusions
The results of this study demonstrate that intravenous dexmedetomidine injection can significantly prolong the duration of spontaneous breathing in the prone position in elderly pneumonia patients without obvious adverse events. We provide a safe and effective method to help patients with pneumonia, especially those with delirium or cognitive impairment, who cannot tolerate the length of time needed for spontaneous breathing in the prone position to be effective.
Trial registration: The study was registered with the Chinese Clinical Trial Center (registration number: ChiCRT2300067383) on 2023-01-05.
Publisher
Springer US,Springer,Springer Nature B.V
Subject
Adrenergic alpha-2 Receptor Agonists - administration & dosage
/ Adrenergic alpha-2 Receptor Agonists - adverse effects
/ Adrenergic alpha-2 Receptor Agonists - therapeutic use
/ Aged
/ ChiCRT
/ Chloride
/ Chronic obstructive pulmonary disease
/ COVID-19
/ Dexmedetomidine - administration & dosage
/ Dexmedetomidine - adverse effects
/ Dexmedetomidine - therapeutic use
/ Female
/ Humans
/ Male
/ Medicine
/ Patient Positioning - methods
/ Patients
/ Placebos
/ Pneumology/Respiratory System
/ Sodium
