The Application Of Dexmedetomidine In Mechanical Ventilation Weaning Of Critically Ill Patients

Objective:This study was to observe intubation in mechanically ventilated patient from the ventilator before the application of the general Information of dexmedetomidi-ne,it is influence to the function of hemodynamic and respiratory and to evaluate the application effect before weaning.Methods: The study included from June 2014 to December 2014 admitted to our hospital a total of 96 cases in ICU patients, met the inclusion criteria were randomlyd ivided into three group: group A:dexmedetomidine group(n=32),group B:propofol gro-up(n=34),group C:control group(n=30). Observed general information of the patient and before weaning 4h, before weaning 2h, weaning 0h following indicators:1 General Information(sex,age,APACHE Ⅱ,disease constitutes).2 Hemodynamic parameters(HR,MAP).3 Respiratory function parameters(RR, Sa O2, Pa O2, Pa CO2,RI).4. Weaning Parameters(PImax,P0.1,CORE, RSBI).5 State of consciousness(SAS score, CAM-ICU).All indic-ators were statistically analyzed to assess.Data are expressed as mean±SD.Count data were compared using Chi-square test. Comparision of measurment data was using anal-ysis of variance(ANOVA).Results:①General Information: Three group of patients,such as sex,age,APACHE Ⅱ, disease constitutes between groups was no statisticant difference(P> 0.05).②Hemod-ynamic Parameters:before weaning 4h,before weaning 2h, weaning 0h HR and MAP o-f three groups between groups was not statistically significant(P> 0.05).③Respiratory Function Parameters: a RR: before weaning 4h RR of group B is lower than group C and group A,group A and group B or group B an-d group C of RR were significa-ntly different(P <0.05), group A and group C of RR was not statistically significant(P>0.0 5);before weaning 2h, weaning 0h three groups between groups was not statisti-cally significant(P>0.05).b Pa CO2:before weaning 4h Pa CO2 of group B is higher thangroup C and group A,group B and group C of Pa CO2 were significantly different(P<0.05), group A and group B or group A and group C of Pa CO2 was not statistically significant( P>0.05);before weaning 2h, weaning 0h three groups between groups wasnot statitically significant(P>0.05). c. Sa O2,Pa O2,Pa O2/Fi O2: before weaning 4h,beforeweaning 2h, weaning 0h the three groups between groups was not statistically significant(P>0.05). ④Weaning Parameters: a. PImax:before weaning 4h PImax of group B is higher than group C and group A,group A and group B were significantly different(P<0.05),group B and group C or group A and group C was not statistically significant(P> 0.05).before weaning 2h, weaning 0h three group between groups had no significant difference(P> 0.05). b. P0.1:before weaning 4h,before weaning 2h, weaning 0h three group between groups had no significant difference(P> 0.05).c CORE:CORE(≤8)of group A respectively has two and one patients that can not predict weaning before weaning 2h and in weaning 0h, CORE(≤8) of group B has one patient that can not p-redict weaning in weaning 0h, CORE(≤8) of group C respectively has two and two p-atients that can not predict weaning before weaning 4h and in weaning 0h.d RSBI: R-SBI(85~105) of group C has one patient that predict cautious in weaning 0h; RSBI(<85) of three groups of others patients can predict weaning before weaning 4h and before weaning 2h and weaning 0h.⑤a SAS score: before weaning 4h SAS score of group B is lower than group C andgroup A,group A and group B were significantly different(P <0.05), group B and gro-up C or group A and group C was not statistica-lly significant( P> 0.05)。before weaning 2h, weaning 0h three groups between groups no significant difference(P> 0.05). b CAM-ICU :All patients had no delirium.Conclusion:a The application of dexmedetomidine before weaning for dynamics,re-spiratory function has no effect.b Dexmedetomidine given not affect the determination of the ventilator weaning parameters and can be used for mechanical process of weani-ng.