Abstract：
BACKGROUND: The incidence of hyperactive brain syndrome in patients in the intensive care unit (ICU) is very high. Compared with other sedative drugs, existing research shows that dexmedetomidine can significantly reduce the incidence of hyperactive brain syndrome. This study systematically analyzed the clinical efficacy of a dexmedetomidine intravenous injection in ICU patients with hyperactive brain syndrome.
METHODS: The databases PubMed, Web of Science, Embase, and the Cochrane Library were searched from January 2000 to December 2020 to identify papers that studied the clinical efficacy of dexmedetomidine intravenous injection in ICU patients with hyperactive brain syndrome. The basic information and evaluation indexes in the literature were screened and extracted. Revman5.3 software was used for quality assessment and meta-analysis of the included studies, and forest maps were drawn.
RESULTS: A total of 255 patients were included in 5 studies. The results of the meta-analysis showed that intravenous infusion of dexmedetomidine could reduce the incidence of restless delirium in patients [odds ratio (OR) =0.14; 95% confidence interval (CI): 0.07 to 0.29; (Z test) Z=5.39, P<0.00001], total delirium after medication duration [mean difference (MD) =-15.50; 95% CI: -25.70 to -5.29; Z=2.98; P=0.003], and ICU hospitalization time (MD =-1.93; 95% CI: -3.57 to -0.29; Z=2.31; P=0.02). However, there was no significant difference in the incidence of adverse reactions (bradycardia and hypotension) in patients who were given an intravenous infusion of dexmedetomidine (OR =2.85; 95% CI: 0.21 to 38.74; Z=0.79; P=0.43).
CONCLUSIONS: The incidence of restlessness delirium, the duration of total delirium after medication, and the length of ICU stay in patients treated with a dexmedetomidine intravenous injection were significantly lower than those in patients treated with haloperidol, indicating that a dexmedetomidine intravenous injection had clinical efficacy in ICU patients with hyperactive brain syndrome.
METHODS: The databases PubMed, Web of Science, Embase, and the Cochrane Library were searched from January 2000 to December 2020 to identify papers that studied the clinical efficacy of dexmedetomidine intravenous injection in ICU patients with hyperactive brain syndrome. The basic information and evaluation indexes in the literature were screened and extracted. Revman5.3 software was used for quality assessment and meta-analysis of the included studies, and forest maps were drawn.
RESULTS: A total of 255 patients were included in 5 studies. The results of the meta-analysis showed that intravenous infusion of dexmedetomidine could reduce the incidence of restless delirium in patients [odds ratio (OR) =0.14; 95% confidence interval (CI): 0.07 to 0.29; (Z test) Z=5.39, P<0.00001], total delirium after medication duration [mean difference (MD) =-15.50; 95% CI: -25.70 to -5.29; Z=2.98; P=0.003], and ICU hospitalization time (MD =-1.93; 95% CI: -3.57 to -0.29; Z=2.31; P=0.02). However, there was no significant difference in the incidence of adverse reactions (bradycardia and hypotension) in patients who were given an intravenous infusion of dexmedetomidine (OR =2.85; 95% CI: 0.21 to 38.74; Z=0.79; P=0.43).
CONCLUSIONS: The incidence of restlessness delirium, the duration of total delirium after medication, and the length of ICU stay in patients treated with a dexmedetomidine intravenous injection were significantly lower than those in patients treated with haloperidol, indicating that a dexmedetomidine intravenous injection had clinical efficacy in ICU patients with hyperactive brain syndrome.
摘要：
背景：重症监护病房（ICU）患者中脑活动过度综合征的发生率很高。与其他镇静药物相比，现有研究表明右美托咪定可显著降低脑多动综合征的发生率。本研究系统分析右美托咪定静脉注射在ICU脑多动综合征患者中的临床疗效。
方法：数据库PubMed，WebofScience,Embase,从2000年1月至2020年12月检索Cochrane图书馆，以确定研究右美托咪定静脉注射在ICU脑活动过度综合征患者中的临床疗效的论文。对文献中的基本信息和评价指标进行筛选和提取。采用Revman5.3软件对纳入研究进行质量评价和荟萃分析,绘制了森林地图。
结果：共有255名患者被纳入5项研究。荟萃分析结果显示，静脉输注右美托咪定可降低患者躁动谵妄的发生率[比值比(OR)=0.14；95%置信区间(CI):0.07~0.29；(Z检验)Z=5.39，P<0.00001]，用药后总谵妄[平均差(MD)=-15.50;95%CI:-25.70至-5.29;Z=2.98;P=0.003],和ICU住院时间（MD=-1.93；95％CI：-3.57至-0.29；Z=2.31；P=0.02）。然而,静脉输注右美托咪定患者的不良反应(心动过缓和低血压)发生率无显著差异(OR=2.85;95%CI:0.21~38.74;Z=0.79;P=0.43).
结论：躁动谵妄的发生率，服药后总谵妄的持续时间，右美托咪定静脉注射治疗的患者的ICU住院时间明显低于氟哌啶醇治疗的患者，提示右美托咪定静脉注射对ICU脑多动综合征患者具有临床疗效。
方法：数据库PubMed，WebofScience,Embase,从2000年1月至2020年12月检索Cochrane图书馆，以确定研究右美托咪定静脉注射在ICU脑活动过度综合征患者中的临床疗效的论文。对文献中的基本信息和评价指标进行筛选和提取。采用Revman5.3软件对纳入研究进行质量评价和荟萃分析,绘制了森林地图。
结果：共有255名患者被纳入5项研究。荟萃分析结果显示，静脉输注右美托咪定可降低患者躁动谵妄的发生率[比值比(OR)=0.14；95%置信区间(CI):0.07~0.29；(Z检验)Z=5.39，P<0.00001]，用药后总谵妄[平均差(MD)=-15.50;95%CI:-25.70至-5.29;Z=2.98;P=0.003],和ICU住院时间（MD=-1.93；95％CI：-3.57至-0.29；Z=2.31；P=0.02）。然而,静脉输注右美托咪定患者的不良反应(心动过缓和低血压)发生率无显著差异(OR=2.85;95%CI:0.21~38.74;Z=0.79;P=0.43).
结论：躁动谵妄的发生率，服药后总谵妄的持续时间，右美托咪定静脉注射治疗的患者的ICU住院时间明显低于氟哌啶醇治疗的患者，提示右美托咪定静脉注射对ICU脑多动综合征患者具有临床疗效。
