The Effect Of Dexmedetomidine On The Prognosis Of Patients With Sepsis Or Septic Shock:a Meta-analysis

Objective: To evaluate the effect of dexmedetomidine on prognosis in patients with sepsis or septic shock.Methods:Computer-related electronic databases were searched,including Pubmed database,Cochrane clinical trial database,EMBASE database,Web of Science database,Wanfang database,China Knowledge Network,and Chinese biomedical literature database from the date of database construction to January 2018.Formulate research inclusion and exclusion criteria,evaluate the quality of studies that meet the standards,and conduct data extraction.RevMan 5.3 software was used to perform a meta-analysis of short-term mortality(ICU mortality or 28-day mortality),ICU length of stay,and mechanical ventilation.Mortality was expressed using relative risk(RR)and 95% confidence intervals.ICU length of stay and mechanical ventilation were expressed as standardized mean difference(SMD)and 95% confidence intervals.Results: According to the criteria set out in the literature search strategy,the relevant databases were searched by computer.The language restrictions were English and Chinese.According to the literature inclusion process,9randomized controlled trials(RCTs)were included in the study.Among them,5 were English,4 were Chinese,and 628 were included.patient.Meta-analysis showed that the short-term mortality of dexmedetomidine-treated patients was significantly lower in sepsis or septic shock patients than in the control group(RR=0.64,95% CI=0.46~0.90,P=0.009),but had no significant effect on the length of stay in the ICU.The difference was not statistically significant(SMD=-0.03,95% CI=-0.19~0.13,P=0.72),nor was there any time for mechanical ventilation.There was no statistically significant difference(SMD=0.22,95%CI=-0.01~0.44,P=0.06).Conclusions: In patients with sepsis or septic shock,dexmedetomidine can reduce the short-term mortality of patients,but can not shorten the ICU length of stay and mechanical ventilation time.