新生児の鎮静,痛み,呼吸器系および心血管系に対するデックスメドトミジンの作用
Marjorie M Makoni1, Ivonne Sierra-Strum2, Adrianne R Bischoff3
1Section of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. marjorie-makoni@ouhsc.edu.
まとめ
デックスメデトミジンは,特に他の鎮静剤や鎮痛剤と併用すると,早産児の心血管の不安定性を高める可能性があります. 独特の心臓構造を持つ新生児の 脆弱性を強調しています
科学分野:
- 新生児医療
- 小児重症治療
- 薬理学について
背景:
- デックスメデトミジンは,新生児の鎮静と鎮痛にますます使用されています.
- この脆弱な集団における 血液動力学的効果を理解することは 極めて重要です
研究 の 目的:
- 新生児の鎮静,痛み,呼吸状態,および血動力学に対するデクスメデトミディンの影響を評価する.
- 血液動力学的有害事象に関連する要因を特定する.
主な方法:
- レベルIVのNICUでデクスメドトミジンの連続注入を受けた206人の新生児の遡及分析.
- 疼痛/鎮静スコア,血圧,血管圧縮剤およびイノトロプスコア (VIS),および併用鎮静剤/鎮痛剤 (CSA) のデータを収集する.
- 投与開始前と後の24時間のデータの分析
主要な成果:
- 低血圧は新生児の26%,特に早産の新生児 (PMA < 32週間) で発生しました.
- 高いVISとCSAは低血圧と関連していた.
- 静止薬と鎮痛薬 (CSA) の併用は,血管圧縮薬とイノトロプ薬の必要性を有意に予測した.
結論:
- デックスメデトミジンは,特に鎮静剤と鎮痛剤 (CSA) と併用すると,早産児の心血管不安定性の増加と関連しています.
- 胎児の心筋の構造と機能が独特で 胎児の心筋の構造と機能が独特で 胎児の心筋の構造と機能が独特で 胎児の心筋の構造と機能が独特で 胎児の心筋の構造と機能が独特で
- この集団でデクスメデトミジンを使用する際には,血動力学的モニタリングを注意深く行うことが重要です.
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