Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery.

Abstract

OBJECTIVE:

This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery.

DESIGN:

Retrospective investigation.

SETTING:

Patients from a single tertiary medical center.

PARTICIPANTS:

A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX).

INTERVENTIONS:

Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 µg/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit.

MEASUREMENTS AND MAIN RESULTS:

Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5% and 4.0% (adjusted odds ratio [OR], 0.332; 95% CI, 0.155 to 0.708; p = 0.0044), 2.0% and 4.5% (adjusted OR, 0.487; 95% CI, 0.253 to 0.985; p = 0.0305), and 3.2% and 6.9% (adjusted OR 0.421; 95% CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9% to 4.6% (adjusted OR, 0.431; 95% CI, 0.265-0.701; p = 0.0007).

CONCLUSION:

Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium.

• Authors: Fuhai Ji, Zhongmin Li, Nilas Young, Peter Moore, Hong Liu
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 28 Issue 2 Pg. 267-73 (Apr 2014) ISSN: 1532-8422 [Electronic] United States
• PMID: 24182835 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Adrenergic alpha-Agonists
• Dexmedetomidine

Topics

• Adrenergic alpha-Agonists (administration & dosage, therapeutic use)
• Aged
• Cardiac Surgical Procedures (methods, mortality)
• Cohort Studies
• Coronary Artery Bypass (methods, mortality)
• Delirium (epidemiology)
• Dexmedetomidine (administration & dosage, therapeutic use)
• Electrocardiography
• Female
• Hospital Mortality
• Humans
• Infusions, Intravenous
• Kaplan-Meier Estimate
• Length of Stay
• Logistic Models
• Male
• Middle Aged
• Odds Ratio
• Postoperative Complications (epidemiology)
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Survival Analysis
• Treatment Outcome