Effects of propofol and dexmedetomidine on indocyanine green elimination assessed with LIMON to patients with early septic shock: A pilot study

Küçük Resim Yok

Tarih

2009

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

W B Saunders Co-Elsevier Inc

Erişim Hakkı

info:eu-repo/semantics/closedAccess

Özet

Background: We aimed to select the sedative drug with the least impact on hepatic blood flow in sedation-administered patients. In our study, we aimed to establish whether deximedetomidine and propofol affect liver function during early septic shock. The hepatic blood flow is evaluated by the transcutaneous assessment of indocyanine green plasma disappearance rate (ICG-PDR) in critically ill patients. Methods: Forty early septic shock patients were included in the study and administered either the loading dose infusion of propofol (n = 20, group P) of 1 mg/kg over 15 minutes followed by a maintenance dose of I to 3 mg/kg per hour (n = 20, group P), or a loading dose of dexmedetomidine 1 mu g/kg over 10 minutes followed by a maintenance of 0.2 to 2.5 mu g/kg per hour (n = 20, group D) (24-hour infusion). Indocyanine green (ICG) elimination tests were conducted concurrently using the noninvasive liver function monitoring system (LiMON; Pulsion Medical Systems, Munich, Germany). A dose of 0.3 mg/kg of ICG was given through a cubital fossa vein as a bolus and immediately flushed with 10 mL of normal saline. We Calculated ICG-PDR. Indocyanine green plasma disappearance rate measurements were obtained at baseline (before start of the propofol or dexmedetomidine infusion) and were repeated at the 24th hour. Biochemical and hemodynamic parameters and ICG-PDR were recorded before start of the study and at 24th hour. Results: Biochemical and hemodynamic parameters did not differ significantly between the groups (P<.05). Baseline ICG-PDR levels of group P compared to group D were 24.7 +/- 14.4 vs 21.2 +/- 10.7, respectively, and after the study, ICG-PDR levels (26.5 +/- 13.7 vs 23.7 +/- 12.4) did not differ in groups (P > .05). When we examined ICG-PDR changes between groups before and after administration, there was no significant difference (P > .05). Conclusion: In our study, we found that neither propofol nor dexmedetomidine infusion affected hepatic blood flow. (C) 2009 Elsevier Inc. All rights reserved.

Açıklama

Anahtar Kelimeler

Dexmedetomidine, Propofol, Septic Shock, Indocyanine Green Plasma Disappearance Rate, Plasma Disappearance Rate, End-Expiratory Pressure, Critically-Ill Patients, Pulse Dye-Densitometry, Regional Blood-Flow, Hepatic-Dysfunction, Cirrhotic-Patients, Oxygen-Transport, Hemodynamics, Ventilation

Kaynak

Journal Of Critical Care

WoS Q Değeri

Q3

Scopus Q Değeri

Q1

Cilt

24

Sayı

4

Künye