Dexmedetomidine administration is associated with reduced mortality in patients with sepsis-induced acute respiratory distress syndrome: a retrospective study.

Abstract

Background: Although studies have revealed the benefits of using dexmedetomidine (DEX) in treating rodent models of acute lung injury (ALI) by improving their survival rates, clinical investigation on the effect of DEX on patients with acute respiratory distress syndrome (ARDS) remains scarce. Through this retrospective study, we aim to better understand the underlying mechanism of sepsis-induced ARDS and the effect of DEX on patients' standard treatment.

Methods: A total of 208 patients with sepsis-induced ARDS, admitted to the intensive care unit (ICU) at Affiliated Hospital of Jiangsu University, China, from January 2017 to December 2019, were included. The patients were divided into the control group (n = 102) and the DEX group (n = 106). Both groups of patients received mechanical ventilation and standard care; however, the DEX group was additionally treated with DEX as a sedative. Demographic information, baseline characteristics, laboratory parameters, arterial blood gas (ABG) analyses, and inflammatory indicators were compared between the two groups to evaluate the therapeutic outcomes of different treatment approaches.

Results: Age and male gender constituted risk factors for high ARDS incidence, and hypertension led in the list of patients' comorbidities. The baseline characteristics including primary diagnosis and ARDS causes, and prognostic values such as the Acute Physiology and Chronic Health Evaluation (APACHE) II score and predicted mortality, were comparable between the two groups of patients. However, the multiple organ dysfunction syndrome (MODS) incidence and actual mortality rate were significantly lower in the DEX group compared to the control group. Additionally, the DEX group demonstrated improved ABG metrics, representing better acid-base balance and oxygenation, and enhanced inflammatory responses.

Conclusions: Intravenous administration of DEX was associated with reduced in-hospital mortality, at least in part, by ameliorating ABG indices and inflammatory mediators.