Clinical study of dexmedetomidine in rescue of septic shock patients

Objective To explore the clinical application of dexmedetomidine in the rescue of septic shock patients. Methods Twenty patients with septic shock admitted in intensive care unit (ICU) ward of Bozhou People's Hospital from June, 2015 to October, 2016 were included in the study. All patients were randomly divided into dexmedetomidine group 10 cases and control group 10 cases, All patients were treated with guideline and positive EGDT fluid recovery, In the dexmedetomidine group, intravenous infusion of dexmedetomidine 0. 2-0. 7 μg/(kg·h), heart rate control in the 60-100 beats/min, the control group on the heart rate is not particularly intervene in the control group. The changes of HR, MAP, stroke volume index (SVI), central venous oxygen saturation (ScvO₂) and blood lactate (Lac) were measured before and 24, 48 and 72 h after treatment. Results Dexmedetomidine group after treatment slowed heart rate, There was significant difference (P < 0. 05) before and after treatment. at the same time compared with the control group, the difference was statistically significant (P < 0. 05). There was no significant difference in the mean arterial blood pressure between the two groups, and there was no significant difference before and after treatment in the dexmedetomidine group.Dexmedetomidine treatment 24 hours ScvO₂ increased, 48 hours SVI increased, There was significant difference (P <0. 05) before and after treatment. at the same time compared with the control group, the difference was statistically significant (P < 0. 05). Dexmedetomidine treatment significantly decreased lactic acid after 48 hours, the difference was statistically significant (P < 0. 05) before and after treatment in the dexmedetomidine group, at the same time compared with the control group, the difference was statistically significant (P < 0. 05). Conclusion In the group of dexmedetomidine, the HR gradually began to slow down, SVI, ScvO₂ gradually increased, Lac gradually decreased, while the MAP no significant change. Compared with the control group, dexmedetomidine treatment significantly reduced HR after 24 hours, ScvO₂ began to rise, 48 h from the ScvO₂ increased significantly, Lac decreased significantly. Dexmedetomidine can improve the oxygen metabolism of the organism by inhibiting sympathetic nerve activity and stabilizing hemodynamics in patients with septic shock.