A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery
Summary Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg−1 for 10 min and then at 0.4 μg.kg−1.h−1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected d...
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| Veröffentlicht in: | Anaesthesia 2023-05, Vol.78 (5), p.571-576 |
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| creator | Wang, H.‐B. Jia, Y. Zhang, C.‐B. Zhang, L. Li, Y.‐N. Ding, J. Wu, X. Zhang, Z. Wang, J.‐H. Wang, Y. Yan, F.‐X. Yuan, S. Sessler, D. I. |
| description | Summary
Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg−1 for 10 min and then at 0.4 μg.kg−1.h−1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected delirium in 98/652 (15%) participants during the first seven postoperative days: 47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted relative risk (95%CI) 0.86 (0.56–1.33), p = 0.51. Postoperative renal impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3) was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7 and 4 control participants, p = 0.040. Intra‐operative dexmedetomidine infusion did not reduce the incidence of delirium after cardiac valve surgery but might impair renal function. |
| doi_str_mv | 10.1111/anae.15983 |
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Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg−1 for 10 min and then at 0.4 μg.kg−1.h−1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected delirium in 98/652 (15%) participants during the first seven postoperative days: 47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted relative risk (95%CI) 0.86 (0.56–1.33), p = 0.51. Postoperative renal impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3) was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7 and 4 control participants, p = 0.040. Intra‐operative dexmedetomidine infusion did not reduce the incidence of delirium after cardiac valve surgery but might impair renal function.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/anae.15983</identifier><identifier>PMID: 36794600</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>acute kidney injury ; Adult ; anaesthesia ; cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; cardiopulmonary bypass ; Delirium - epidemiology ; Delirium - prevention & control ; dexmedetomidine ; Dexmedetomidine - therapeutic use ; Double-Blind Method ; Heart ; Heart surgery ; Heart valves ; Heart Valves - surgery ; Humans ; Incidence ; Kidney diseases ; Mental disorders ; postoperative delirium ; Renal function ; Rheumatic heart disease ; Surgery</subject><ispartof>Anaesthesia, 2023-05, Vol.78 (5), p.571-576</ispartof><rights>2023 Association of Anaesthetists.</rights><rights>Copyright © 2023 Association of Anaesthetists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3573-3b518e28d0dd3c9a9e24c292b197e104cbb022e9a5dc1636a54ce696f20b16f63</citedby><cites>FETCH-LOGICAL-c3573-3b518e28d0dd3c9a9e24c292b197e104cbb022e9a5dc1636a54ce696f20b16f63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fanae.15983$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fanae.15983$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45553,45554,46388,46812</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36794600$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, H.‐B.</creatorcontrib><creatorcontrib>Jia, Y.</creatorcontrib><creatorcontrib>Zhang, C.‐B.</creatorcontrib><creatorcontrib>Zhang, L.</creatorcontrib><creatorcontrib>Li, Y.‐N.</creatorcontrib><creatorcontrib>Ding, J.</creatorcontrib><creatorcontrib>Wu, X.</creatorcontrib><creatorcontrib>Zhang, Z.</creatorcontrib><creatorcontrib>Wang, J.‐H.</creatorcontrib><creatorcontrib>Wang, Y.</creatorcontrib><creatorcontrib>Yan, F.‐X.</creatorcontrib><creatorcontrib>Yuan, S.</creatorcontrib><creatorcontrib>Sessler, D. I.</creatorcontrib><title>A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg−1 for 10 min and then at 0.4 μg.kg−1.h−1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected delirium in 98/652 (15%) participants during the first seven postoperative days: 47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted relative risk (95%CI) 0.86 (0.56–1.33), p = 0.51. Postoperative renal impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3) was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7 and 4 control participants, p = 0.040. Intra‐operative dexmedetomidine infusion did not reduce the incidence of delirium after cardiac valve surgery but might impair renal function.</description><subject>acute kidney injury</subject><subject>Adult</subject><subject>anaesthesia</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>cardiopulmonary bypass</subject><subject>Delirium - epidemiology</subject><subject>Delirium - prevention & control</subject><subject>dexmedetomidine</subject><subject>Dexmedetomidine - therapeutic use</subject><subject>Double-Blind Method</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Heart valves</subject><subject>Heart Valves - surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Mental disorders</subject><subject>postoperative delirium</subject><subject>Renal function</subject><subject>Rheumatic heart disease</subject><subject>Surgery</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90EFPHCEUB3Biaupqe-kHaEh6aUxmfcAMMxw3Rm0Toxd7njDwZothwcKMdr-96K499CAXCPnln_f-hHxhsGTlnOmgccka1YkDsmBCNhWHuv5AFgAgKl6DOiLHOd8DMN6x7iM5ErJVtQRYkHFFkw42blxGS00MU4rel-eUnPY0jtTi3w1anAqxLiAdYyp_3iU3b6gLVNvZT5nOwWJaRxfW9DfqNNFH7R-R5jmtMW0_kcNR-4yf9_cJ-XV5cXf-o7q-vfp5vrqujGhaUYmhYR3yzoK1wiitkNeGKz4w1SKD2gwDcI5KN9YwKaRuaoNSyZHDwOQoxQn5vst9SPHPjHnqy2IGvdcB45x73rZtDUKKptBv_9H7OKdQpitKNSC46FhRpztlUsw54dg_JLfRadsz6F_a71_a71_bL_jrPnIeSmf_6FvdBbAdeHIet-9E9aub1cUu9BnPcI_G</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Wang, H.‐B.</creator><creator>Jia, Y.</creator><creator>Zhang, C.‐B.</creator><creator>Zhang, L.</creator><creator>Li, Y.‐N.</creator><creator>Ding, J.</creator><creator>Wu, X.</creator><creator>Zhang, Z.</creator><creator>Wang, J.‐H.</creator><creator>Wang, Y.</creator><creator>Yan, F.‐X.</creator><creator>Yuan, S.</creator><creator>Sessler, D. I.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>202305</creationdate><title>A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery</title><author>Wang, H.‐B. ; Jia, Y. ; Zhang, C.‐B. ; Zhang, L. ; Li, Y.‐N. ; Ding, J. ; Wu, X. ; Zhang, Z. ; Wang, J.‐H. ; Wang, Y. ; Yan, F.‐X. ; Yuan, S. ; Sessler, D. I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3573-3b518e28d0dd3c9a9e24c292b197e104cbb022e9a5dc1636a54ce696f20b16f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>acute kidney injury</topic><topic>Adult</topic><topic>anaesthesia</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>cardiopulmonary bypass</topic><topic>Delirium - epidemiology</topic><topic>Delirium - prevention & control</topic><topic>dexmedetomidine</topic><topic>Dexmedetomidine - therapeutic use</topic><topic>Double-Blind Method</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Heart valves</topic><topic>Heart Valves - surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney diseases</topic><topic>Mental disorders</topic><topic>postoperative delirium</topic><topic>Renal function</topic><topic>Rheumatic heart disease</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, H.‐B.</creatorcontrib><creatorcontrib>Jia, Y.</creatorcontrib><creatorcontrib>Zhang, C.‐B.</creatorcontrib><creatorcontrib>Zhang, L.</creatorcontrib><creatorcontrib>Li, Y.‐N.</creatorcontrib><creatorcontrib>Ding, J.</creatorcontrib><creatorcontrib>Wu, X.</creatorcontrib><creatorcontrib>Zhang, Z.</creatorcontrib><creatorcontrib>Wang, J.‐H.</creatorcontrib><creatorcontrib>Wang, Y.</creatorcontrib><creatorcontrib>Yan, F.‐X.</creatorcontrib><creatorcontrib>Yuan, S.</creatorcontrib><creatorcontrib>Sessler, D. I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, H.‐B.</au><au>Jia, Y.</au><au>Zhang, C.‐B.</au><au>Zhang, L.</au><au>Li, Y.‐N.</au><au>Ding, J.</au><au>Wu, X.</au><au>Zhang, Z.</au><au>Wang, J.‐H.</au><au>Wang, Y.</au><au>Yan, F.‐X.</au><au>Yuan, S.</au><au>Sessler, D. I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2023-05</date><risdate>2023</risdate><volume>78</volume><issue>5</issue><spage>571</spage><epage>576</epage><pages>571-576</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><abstract>Summary
Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg−1 for 10 min and then at 0.4 μg.kg−1.h−1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected delirium in 98/652 (15%) participants during the first seven postoperative days: 47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted relative risk (95%CI) 0.86 (0.56–1.33), p = 0.51. Postoperative renal impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3) was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7 and 4 control participants, p = 0.040. Intra‐operative dexmedetomidine infusion did not reduce the incidence of delirium after cardiac valve surgery but might impair renal function.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>36794600</pmid><doi>10.1111/anae.15983</doi><tpages>576</tpages></addata></record> |
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| subjects | acute kidney injury Adult anaesthesia cardiac surgery Cardiac Surgical Procedures - adverse effects cardiopulmonary bypass Delirium - epidemiology Delirium - prevention & control dexmedetomidine Dexmedetomidine - therapeutic use Double-Blind Method Heart Heart surgery Heart valves Heart Valves - surgery Humans Incidence Kidney diseases Mental disorders postoperative delirium Renal function Rheumatic heart disease Surgery |
| title | A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery |
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