A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury.
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| Title: | A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury. |
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| Authors: | Lu, Shitao (AUTHOR), Song, Haiying (AUTHOR), Lin, Yuxin (AUTHOR), Song, Bo (AUTHOR), Lin, Sheng (AUTHOR) |
| Source: | Neurological Sciences. Apr2025, Vol. 46 Issue 4, p1741-1750. 10p. |
| Subjects: | Statistical significance, Brain injuries, Jugular vein, Lung infections, Inflammatory mediators |
| Abstract: | Objective: The aim of this study is to assess the neuroprotective efficacy of early goal-directed sedation (EGDS) primarily governed by dexmedetomidine in patients experiencing severe traumatic brain injury, and to elucidate its potential underlying mechanisms. Data and methods: All participants were randomly allocated into two groups: the experimental group—dexmedetomidine-dominated EGDS group (group D, n = 30) and the control group—the standard propofol sedation group (group P, n = 30). Patients in the experimental group received sedation primarily with dexmedetomidine, while those in the control group received propofol sedation. Subsequently, retrograde catheterization of the internal jugular vein on the affected side was performed, blood gas analysis samples were collected, cerebral oxygen extraction rates were computed, and levels of interleukin 6 (IL-6) and interleukin 1β (IL-1β) were assessed. One-way ANOVA and Chi-square tests were used for statistical analysis. Results: In group D, significant reductions were observed in the duration of ventilator dependency (p < 0.05).Compared to those documented in group P, tracheostomy incidence, and pulmonary infection rates were no different (p > 0.05). On the second, third and the seventh day, the SjvO2 levels in group D exhibited a statistically significant elevation compared to group P, while the CERO2 levels were notably lower in group D than in group P (p < 0.05). The GCS scores of patients in group D was significantly higher than that of the patients in group P and the baseline value on the seventh day and the time of discharge (p < 0.05). Additionally, the IL-6 levels in group D were significantly lower than those in group P and their corresponding baseline levels on the third and seventh days (p < 0.05). The IL-1β levels were no significant difference between the two groups. Conclusion: A predominance of dexmedetomidine in EGDS demonstrates efficacy in reducing the duration of ICU stay and ventilator dependency, enhancing cerebral oxygen metabolism, and attenuating the infiltration of inflammatory factors. [ABSTRACT FROM AUTHOR] |
| Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 183814393 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Lu%2C+Shitao%22">Lu, Shitao</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Song%2C+Haiying%22">Song, Haiying</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin%2C+Yuxin%22">Lin, Yuxin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Song%2C+Bo%22">Song, Bo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin%2C+Sheng%22">Lin, Sheng</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Apr2025, Vol. 46 Issue 4, p1741-1750. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Statistical+significance%22">Statistical significance</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+injuries%22">Brain injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Jugular+vein%22">Jugular vein</searchLink><br /><searchLink fieldCode="DE" term="%22Lung+infections%22">Lung infections</searchLink><br /><searchLink fieldCode="DE" term="%22Inflammatory+mediators%22">Inflammatory mediators</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective: The aim of this study is to assess the neuroprotective efficacy of early goal-directed sedation (EGDS) primarily governed by dexmedetomidine in patients experiencing severe traumatic brain injury, and to elucidate its potential underlying mechanisms. Data and methods: All participants were randomly allocated into two groups: the experimental group—dexmedetomidine-dominated EGDS group (group D, n = 30) and the control group—the standard propofol sedation group (group P, n = 30). Patients in the experimental group received sedation primarily with dexmedetomidine, while those in the control group received propofol sedation. Subsequently, retrograde catheterization of the internal jugular vein on the affected side was performed, blood gas analysis samples were collected, cerebral oxygen extraction rates were computed, and levels of interleukin 6 (IL-6) and interleukin 1β (IL-1β) were assessed. One-way ANOVA and Chi-square tests were used for statistical analysis. Results: In group D, significant reductions were observed in the duration of ventilator dependency (p < 0.05).Compared to those documented in group P, tracheostomy incidence, and pulmonary infection rates were no different (p > 0.05). On the second, third and the seventh day, the SjvO2 levels in group D exhibited a statistically significant elevation compared to group P, while the CERO2 levels were notably lower in group D than in group P (p < 0.05). The GCS scores of patients in group D was significantly higher than that of the patients in group P and the baseline value on the seventh day and the time of discharge (p < 0.05). Additionally, the IL-6 levels in group D were significantly lower than those in group P and their corresponding baseline levels on the third and seventh days (p < 0.05). The IL-1β levels were no significant difference between the two groups. Conclusion: A predominance of dexmedetomidine in EGDS demonstrates efficacy in reducing the duration of ICU stay and ventilator dependency, enhancing cerebral oxygen metabolism, and attenuating the infiltration of inflammatory factors. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10072-024-07916-8 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1741 Subjects: – SubjectFull: Statistical significance Type: general – SubjectFull: Brain injuries Type: general – SubjectFull: Jugular vein Type: general – SubjectFull: Lung infections Type: general – SubjectFull: Inflammatory mediators Type: general Titles: – TitleFull: A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Lu, Shitao – PersonEntity: Name: NameFull: Song, Haiying – PersonEntity: Name: NameFull: Lin, Yuxin – PersonEntity: Name: NameFull: Song, Bo – PersonEntity: Name: NameFull: Lin, Sheng IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 15901874 Numbering: – Type: volume Value: 46 – Type: issue Value: 4 Titles: – TitleFull: Neurological Sciences Type: main |
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