Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)66910.18786/2072-0505-2017-45-8-652-657ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИSedation with dexmedetomidine reduces the duration of delirium treatment in sufferers with severe concomitant traumaСедация дексмедетомидином сокращает сроки лечения делирия у пострадавших с тяжелой сочетанной травмойBershadskiyF. F.БершадскийФ. Ф.
Russian Federation

MD, Research Fellow, Department of Anesthesiology and Intensive Care

науч. сотр., отделение реаниматологии

UlitkinaO. N.УлиткинаО. Н.
Russian Federation

MD, Research Fellow, Department of Anesthesiology and Intensive Care

науч. сотр., отделение реаниматологии

SkripkinYu. V.СкрипкинЮ. В.
Russian Federation

MD, PhD, Head of the Intensive Care Unit

канд. мед. наук, заведующий отделением реанимации и интенсивной терапии № 1

LikhvantsevV. V.ЛихванцевВ. В.
Russian Federation

MD, PhD, Professor, Head of the Department of Anesthesiology and Intensive Care

д-р мед. наук, профессор, руководитель отделения реаниматологии

lik0704@gmail.comMoscow Regional Research and Clinical Institute (MONIKI)ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»Moscow Regional Research and Clinical Institute (MONIKI)ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского151220174586526570102201801022018Copyright ©; 2017, Bershadskiy F.F., Ulitkina O.N., Skripkin Y.V., Likhvantsev V.V.Copyright ©; 2017, Бершадский Ф.Ф., Улиткина О.Н., Скрипкин Ю.В., Лихванцев В.В.2017Bershadskiy F.F., Ulitkina O.N., Skripkin Y.V., Likhvantsev V.V.Бершадский Ф.Ф., Улиткина О.Н., Скрипкин Ю.В., Лихванцев В.В.https://creativecommons.org/licenses/by/4.0https://almclinmed.ru/jour/article/view/669

Rationale: Delirium would deteriorate the outcomes and treatment results in the patients with severe concomitant trauma. Its treatment efficacy is especially relevant for such patients. Aim: To identify an optimal sedation strategy for delirium in the sufferers with severe concomitant trauma. Materials and methods: Sixty (60) patients with delirium that developed against the background of severe concomitant trauma were included into this randomized, retrospective-prospective study. One group of patients (n=30) was sedated with dexmedetomidine, the other one (n=30), with propofol. Results: In the group with dexmedetomidine sedation, the duration of delirium was 6 [5–6] days, whereas in the propofol group, 7 [6–8] days (p=0.003). The type of sedation was not associated with the severity of delirium, whose maximum ICDSC score was 7 [4–7] points in the propofol group and 6 [4–6] points in the dexmedetomidine group (p=0.32). Conclusion: Compared to propofol, dexmedetomidine may help to reduce the duration of treatment for non-specific delirium in severe concomitant trauma by 1 day.

 

Актуальность. Делирий ухудшает прогноз и результаты лечения пострадавших с  тяжелой сочетанной травмой. Эффективность его лечения особенно актуальна для таких пациентов. Цель  – определение оптимального метода седации при возникновении делирия у  пострадавших с  тяжелой сочетанной травмой. Материал и  методы. В  рандомизированное ретроспективно-проспективное исследование вошли 60 пациентов с  делирием, развившимся на фоне тяжелой сочетанной травмы. Одна группа пациентов (n=30) получала седацию дексмедетомидином, вторая (n=30)  – пропофолом. Результаты. В  группе седации дексмедетомидином продолжительность делирия составила 6  [5–6] дней, пропофолом  – 7  [6–8] дней (р=0,003). Вид седации не влиял на степень выраженности делирия, максимальная оценка которого по шкале ICDSC составила в группе седации пропофолом 7 [4–7] баллов, дексмедетомидином  – 6  [4–6] баллов (р=0,32). Вывод. Использование дексмедетомидина в  сравнении с  пропофолом сокращает сроки лечения неспецифического делирия при тяжелой сочетанной травме на 1 сутки.

 

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