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La asociación entre el uso de dexmedetomidina y el delirio en pacientes quirúrgicos en estado crítico: un estudio de
Jiwoo Suh1, KyeongTeak Oh2, JiYeon Choi3,4
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Korean journal of anesthesiology
|September 3, 2025
Resumen
El uso de dexmedetomidina en unidades quirúrgicas de cuidados intensivos se relacionó con un aumento de la incidencia de delirio y una mayor permanencia en UCI. Esto sugiere la necesidad de estrategias de sedación personalizadas, no de uso rutinario para la prevención del delirio.
Área de la Ciencia:
- Medicina de cuidados intensivos
- Farmacología
- Resultados quirúrgicos
Sus antecedentes:
- El delirio es una complicación frecuente en pacientes críticos.
- La dexmedetomidina es un agente sedante utilizado en unidades de cuidados intensivos (UCI).
Objetivo del estudio:
- Para analizar las tendencias en el uso de dexmedetomidina.
- Investigar la asociación entre la dexmedetomidina y la incidencia, la gravedad y los resultados del delirio en la UCI quirúrgica.
Principales métodos:
- Estudio de cohorte retrospectivo de 6.140 pacientes adultos en una UCI quirúrgica de Corea del Sur (2017-2023).
- Los pacientes se clasificaron por exposición a la dexmedetomidina.
- El delirio se evaluó utilizando la Lista de Control de Cribado del Delirio en Cuidados Intensivos (ICDSC); los resultados incluyeron la duración de la estancia en UCI y la supervivencia de un año.
Principales resultados:
- El uso de dexmedetomidina aumentó durante el período de estudio.
- Los pacientes que recibieron dexmedetomidina mostraron una mayor incidencia de delirio (46,1% frente a 13,9%) y estadías más largas en UCI (5,7 frente a 2,1 días).
- El uso de dexmedetomidina fue un factor de riesgo independiente para el delirio (OR 3.14); la supervivencia a un año fue menor en este grupo (92,7% frente a 94,5%).
Conclusiones:
- La dexmedetomidina se administró principalmente a pacientes gravemente enfermos de alto riesgo, lo que indica su uso para el tratamiento de los síntomas en lugar de la prevención del delirio.
- Los hallazgos subrayan la necesidad de enfoques de sedación adaptados para optimizar la utilización de la dexmedetomidina en UCI.
Palabras clave:
Cuidados intensivosEl delirioLa dexmedetomidinaLos hipnóticosUnidad de cuidados intensivosFactores de riesgoLos sedantesMás Videos Relacionados
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