Association between dexmedetomidine use and neurological outcomes in aneurysmal subarachnoid hemorrhage patients: A retrospective observational study

J Crit Care. 2018 Apr:44:111-116. doi: 10.1016/j.jcrc.2017.10.034. Epub 2017 Oct 24.

Abstract

Purpose: Recent studies in animal subarachnoid hemorrhage (SAH) models have reported that dexmedetomidine (DEX) use demonstrates significantly better neurological outcomes. This study aimed to evaluate whether DEX use is associated with favorable neurological outcomes (FO) in SAH patients.

Materials and methods: We retrospectively reviewed all SAH patients between 2009 and 2017. We calculated the total dosage of DEX administered for the first 24h after admission. All patients were classified into no use, low dosage, and standard dosage group. Multivariate analysis was performed to clarify the association between DEX use and FO (modified Ranking Scale score of 0-2 at hospital discharge).

Results: There were 161 patients with 55.3% of FO. On univariate analysis, there were significant differences with regard to age, Hunt and Kosnik (H&K) grade, and DEX use. Multivariate analysis showed that age, H&K grade, and low dosage DEX (rather than no use) (odds ratio (OR) 3.17; 95% confidence interval (CI), 1.24-8.53; p=0.02) were significantly associated with FO. However, standard dosage DEX was not a significant factor (OR, 0.75; 95% CI, 0.25-2.16; p=0.59).

Conclusions: Low dosage DEX during the first 24h after admission was associated with FO in SAH patients.

Keywords: Aneurysmal subarachnoid hemorrhage; Dexmedetomidine; Neurological outcome.

Publication types

  • Observational Study

MeSH terms

  • Adrenergic alpha-2 Receptor Agonists / therapeutic use*
  • Adult
  • Aged
  • Dexmedetomidine / adverse effects
  • Dexmedetomidine / therapeutic use*
  • Disability Evaluation
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Hypnotics and Sedatives / therapeutic use*
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / drug therapy*
  • Lactates / blood
  • Logistic Models
  • Male
  • Middle Aged
  • Nervous System Diseases / diagnosis*
  • Neurologic Examination
  • Retrospective Studies
  • Subarachnoid Hemorrhage / complications
  • Subarachnoid Hemorrhage / drug therapy*

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Hypnotics and Sedatives
  • Lactates
  • Dexmedetomidine