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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La dexmedetomidina&#44; un agonista adren&#233;rgico selectivo &#945;2&#44; constituye un intento de mejorar la sedoanalgesia de los pacientes cr&#237;ticos&#44; por sus efectos distintivos en comparaci&#243;n a los planes tradicionales como son&#58; sedaci&#243;n consciente&#44; simpaticolisis y ausencia de depresi&#243;n respiratoria&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudiar el efecto de la dexmedetomidina&#44; un nuevo agonista &#945;28&#44; sobre la hemodin&#225;mica intracraneal y sobre los par&#225;metros hemometab&#243;licos cerebrales en un grupo de pacientes con trauma craneoencef&#225;lico grave&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de los pacientes con lesi&#243;n encef&#225;lica traum&#225;tica grave &#40;Glasgow Coma Scale &#8804; 8&#41; ingresados en un Centro de Tratamiento Intensivo &#40;CTI&#41; que recibieron monitorizaci&#243;n de la presi&#243;n intracraneal &#40;PIC&#41; y monitorizaci&#243;n de saturaci&#243;n de O<span class="elsevierStyleInf">2</span> del bulbo yugular &#40;SjO<span class="elsevierStyleInf">2</span>&#41;&#46; Se realiz&#243; una perfusi&#243;n intravenosa de la droga durante 3 horas&#44; en dosis progresivas &#40;0&#46;2&#44; 0&#46;4 y 0&#46;7<span class="elsevierStyleHsp" style=""></span>ug&#47;kg&#47;h&#41;&#44; previa suspensi&#243;n de otros sedantes y analg&#233;sicos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 12 pacientes sin hiperten-si&#243;n intracraneal&#46; No se encontraron diferencias significativas entre los valores de PIC y presi&#243;n arterial media &#40;PAM&#41; tras la infusi&#243;n de la droga en relaci&#243;n con los valores basales&#46; La presi&#243;n de perfusi&#243;n cerebral &#40;PPC&#41; mostr&#243; una tendencia a disminuir durante el estudio &#40;efecto marginal&#44; p&#61;0&#46;058&#41;&#46; Se encontr&#243; un descenso significativo de la frecuencia card&#237;aca &#40;FC&#41; &#40;p&#60;0&#46;0001&#41; en relaci&#243;n a los valores basales&#46; No se hallaron diferencias significativas en los par&#225;metros hemometab&#243;licos cerebrales &#40;SjO<span class="elsevierStyleInf">2</span> y CEO<span class="elsevierStyleInf">2</span>&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A las dosis utilizadas&#44; la dexmede-tomidina fue segura&#44; no asoci&#225;ndose a alteraciones significativas de la hemodin&#225;mica intracraneal ni del metabolismo sangu&#237;neo cerebral en pacientes en la etapa aguda del trauma craneoencef&#225;lico grave &#40;TECG&#41;</p>"
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        "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Dexmedetomidine&#44; an &#945;2 adrenergic agonist&#44; with distinctive characteristics when compared to traditional plans&#44; namely&#58; conscious sedation&#44; sympatholysis and lack of respiratory depression&#44; represents an attempt to improve the sedoanalgesia of critically ill patients&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To study dexmedetomidine&#39;s effect on intracranial hemodynamic and hemometabolic parameters in severe head injured patients&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Prospective study on the effect of Dexmedetomidine on twelve severe head injured patients &#40;Glasgow Coma Scale score &#8804; 8&#41; admitted to an intensive care unit&#44; with intracranial pressure &#60; 20<span class="elsevierStyleHsp" style=""></span>mmHg and O<span class="elsevierStyleInf">2</span> saturation monitoring of blood from jugular bulb&#46; The drug was perfused intravenously during 3 hours&#44; in progressive doses &#40;0&#46;2&#44; 0&#46;4 y 0&#46;7<span class="elsevierStyleHsp" style=""></span>ug&#47;kg&#47;h&#41;&#46; All other sedo-analgesia medication had been previously withdrawn&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">No significant differences were found in intracranial pressure&#44; mean arterial pressure and cerebral hemometabolic parameters after infusion of dexmedetomidine in relation to basal values&#46; Cerebral perfusion pressure showed a trend to decrease during the drug infusion &#40;marginal effect&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;058&#41;&#46; Cardiac frequency decreased significantly after the drug administration&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">At the doses utilized&#44; dexmedetomidine was safe&#44; and it was not associated with significant changes in intracranial hemodynamics&#44; nor in cerebral hemometabolic parameters&#44; in a group of severe head jnjured patients&#46;</p>"
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Vol. 16. Núm. 5.
Páginas 411-417 (enero 2004)
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Vol. 16. Núm. 5.
Páginas 411-417 (enero 2004)
Efectos de la dexmedetomidina sobre la hemodinámica intracraneal en pacientes con lesión encefálica traumatica grave
Effects of dexmedetomidine on intracranial hemodynamics in severe head injured patients
Visitas
1883
P. Grille, A. Biestro
, G. Fariña, R. Miraballes
Unidad de Cuidados Intensivo. Hospital de Clínicas. Universidad de la República. Montevideo. Uruguays
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Resumen

La dexmedetomidina, un agonista adrenérgico selectivo α2, constituye un intento de mejorar la sedoanalgesia de los pacientes críticos, por sus efectos distintivos en comparación a los planes tradicionales como son: sedación consciente, simpaticolisis y ausencia de depresión respiratoria.

Objetivo

Estudiar el efecto de la dexmedetomidina, un nuevo agonista α28, sobre la hemodinámica intracraneal y sobre los parámetros hemometabólicos cerebrales en un grupo de pacientes con trauma craneoencefálico grave.

Material y métodos

Estudio prospectivo de los pacientes con lesión encefálica traumática grave (Glasgow Coma Scale ≤ 8) ingresados en un Centro de Tratamiento Intensivo (CTI) que recibieron monitorización de la presión intracraneal (PIC) y monitorización de saturación de O2 del bulbo yugular (SjO2). Se realizó una perfusión intravenosa de la droga durante 3 horas, en dosis progresivas (0.2, 0.4 y 0.7ug/kg/h), previa suspensión de otros sedantes y analgésicos.

Resultados

Se estudiaron 12 pacientes sin hiperten-sión intracraneal. No se encontraron diferencias significativas entre los valores de PIC y presión arterial media (PAM) tras la infusión de la droga en relación con los valores basales. La presión de perfusión cerebral (PPC) mostró una tendencia a disminuir durante el estudio (efecto marginal, p=0.058). Se encontró un descenso significativo de la frecuencia cardíaca (FC) (p<0.0001) en relación a los valores basales. No se hallaron diferencias significativas en los parámetros hemometabólicos cerebrales (SjO2 y CEO2).

Conclusión

A las dosis utilizadas, la dexmede-tomidina fue segura, no asociándose a alteraciones significativas de la hemodinámica intracraneal ni del metabolismo sanguíneo cerebral en pacientes en la etapa aguda del trauma craneoencefálico grave (TECG)

Palabras clave:
Dexmedetomidina
Lesión encefá-lica traumática grave
Trauma craneal
Presión intracraneal
Presión de perfusión cerebral
Hemodinámica intracraneal
Saturación de oxígeno yugular
Abreviaturas:
APACHE
CEO2
paCO2
CTI
DE
FC
FSC
GCS
HIC
PA
PAM
PIC
PPC
SjO2
TCEG
VSC
Summary

Dexmedetomidine, an α2 adrenergic agonist, with distinctive characteristics when compared to traditional plans, namely: conscious sedation, sympatholysis and lack of respiratory depression, represents an attempt to improve the sedoanalgesia of critically ill patients.

Objective

To study dexmedetomidine's effect on intracranial hemodynamic and hemometabolic parameters in severe head injured patients.

Material and methods

Prospective study on the effect of Dexmedetomidine on twelve severe head injured patients (Glasgow Coma Scale score ≤ 8) admitted to an intensive care unit, with intracranial pressure < 20mmHg and O2 saturation monitoring of blood from jugular bulb. The drug was perfused intravenously during 3 hours, in progressive doses (0.2, 0.4 y 0.7ug/kg/h). All other sedo-analgesia medication had been previously withdrawn.

Results

No significant differences were found in intracranial pressure, mean arterial pressure and cerebral hemometabolic parameters after infusion of dexmedetomidine in relation to basal values. Cerebral perfusion pressure showed a trend to decrease during the drug infusion (marginal effect, p=.058). Cardiac frequency decreased significantly after the drug administration.

Conclusions

At the doses utilized, dexmedetomidine was safe, and it was not associated with significant changes in intracranial hemodynamics, nor in cerebral hemometabolic parameters, in a group of severe head jnjured patients.

Key words:
Dexmedetomidine
Head injury
Head trauma
Intracranial pressure
Cerebral perfusion pressure
Intracranial hemodynamics
Oxygen jugular saturation

Artículo

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