Uso de dexmedetomidina en unidades de cuidados intensivos cardiológicosestudio de eficacia y seguridad

Résumé

Dexmedetomidine is an alfa-2 adrenergic receptor agonist whose attractive pharmacokinetic and pharmacodynamic characteristics have enhanced its use as sedative and analgesic drug. Its ability to induce semi-arousable sedation, rapid start and end of action, and its anxiolytic, hypnotic, analgesic and organ-protective effects become it the ideal sedative. Its use in intensive care units (ICU) have proved to reduce the use of others sedatives, time under mechanical ventilation and hospital admission length; also prevent and treat effectively delirium. The development of cardiac intensive care units (CICU) have widespread the use of sedatives on these units, usual in critical ill patients. Dexmedetomidine use means a challenge in CICUs, due to the potential vulnerability of cardiac critical ill patients to its adverse effects, bradycardia and hypotension, and the lack of experience and evidence among them. The main hypothesis of this work is that dexmedetomidine use is feasible in cardiac critical ill patients, providing several benefits as much as those demonstrated in ICU admitted patients. Despite of potential vulnerability of these patients to its adverse effects, a good safety profile have been described in post-surgical cardiac patients. The main goal of this thesis is to collect information about the real-world pattern of dexmedetomidine use at CICUs, which will allow the safety and efficacy analysis of the drug among these patients. As secondary objectives, clarify the clinical profile of CICUs dexmedetomidine candidates for its use, main indications of its use at CICUs and dexmedetomidine effect on the incidence of delirium...