Abstracts - posterkonkurrence DASAIMs Årsmøde 2014
Postersession VI
Abstract 5
Korresponderende forfatter Peter Buhl Hjortrup
Email peter.buhl.hjortrup@regionh.dk Afdeling Intensiv Terapiklinik 4131 Hospital/institution Rigshospitalet
Medforfattere Nicolai Haase, Jørn Wetterslev og Anders Perner
Titel Patient and site characteristics and volumes of resuscitation fluids in severe sepsis – a post hoc analysis of a randomised clinical trial
Introduction
Fluid resuscitation is a key intervention in patients with sepsis and circulatory impairment, but it is less clear if higher or lower volumes should be given. Beyond the first six hours of resuscitation the recommendations are vague and ungraded (1), and the lack of firm evidence may result in differences in clinical practice.
Our aim was to evaluate associations between patient and site characteristics and volumes of resuscitation fluids in a multicentre randomis- ed clinical trial (RCT).
Methods
This was a retrospective observational study using data from the 6S trial – a multicentre RCT where patients were randomised to resusci- tation with hydroxyethyl starch (HES) 130/0.42 or Ringer’s acetate (2). We defined volume of resuscitation fluids as crystalloids and colloids administered from 24 hours prior to randomisation until day 3 post-randomisation. We used multiple linear regression analyses with baseline characteristics as covariates. The site characteristics Danish hospital (+/-), university hospital (+/-) and individual sites with at least 25 rando- mised patients were separately added as covariates to the model. If missing baseline values were > 5% multiple imputations technique was performed.
Results
Of the trial cohort of 798 patients, we included the 655 patients who had fluid volumes registered from day 0 to 3 (88 had died, 52 were discharged and 3 had missing fluid data). Baseline characteristics are presented in table 1. Mean volume of resuscitation fluids was 7900 ml (SD 4000) and only SAPS II (25% missing) needed multiple imputation. Effects of patient baseline characteristics on fluid volumes are presented in table 2. Patients admitted to a university hospital received significantly less fluid (p=0.049) after adjusting for baseline variables, whereas patients admitted to Danish sites did not (p=0.56). Individual sites administered significantly different volumes of resuscitation fluids after adjusting for baseline variables (p<0.001); in this model weight became significantly associated with increased volumes of resuscitation fluids (p=0.03), whereas SOFA renal score did not (p=0.16). Performing complete case analyses did not change results noticeably.
Conclusions
Site characteristics adjusted for patient baseline values were associated with differences in volumes of resuscitation fluids given in the first 3 days of severe sepsis. The data indicate variations in clinical practice not explained by patient characteristics emphasizing the need for RCTs of fluid volumes given during resuscitation.
References
1. Dellinger RP et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013;41:580–637.
2. Perner A et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med 2012;367:124–34.
Grant Acknowledgement
The 6S trial was funded by the Danish Research Council and supported by B Braun Melsungen AG.
Abstract 17
Korresponderende forfatter Janus Adler Hyldebrandt Email janus.hyldebrandt@ki.au.dk Afdeling Anaesthesiology and Intensive Care Hospital/institution Aarhus University Hospital
Medforfattere P Agger, E Sivén, K Wemmelund, J Heiberg, CA Frederiksen, HB Ravn
Titel Effects of Milrinone and Epinephrine or Dopamine on Biventricular Function and Haemodynamics in an Animal Model with Right Heart Failure After pulmonary regurgitation.
Introduction
Right ventricular failure (RVF) secondary to pulmonary regurgitation (PR) impairs right ventricular (RV) function and interrupts the interven- tricular relationship. There are few recommendations for the medical management of severe RVF after prolonged PR. In this study, the effect of milrinone alone and in combination with epinephrine or dopamine was evaluated.
Methods
PR was induced in 16 pigs and compared to 23 healthy controls. Bi-ventricular performance was evaluated by conductance catheters and haemodynamics by pulmonary artery catheter and pressure transducers during milrinone and either incremental epinephrine (0.04, 0.06 and 0.08 µg/kg/min) or dopamine (4, 6 and 8 µg/kg/min) infusions. Effects were compared using two-way ANOVA, and correlations by Pearson correlation.
Results
Following 11 weeks of PR was, RV end-diastolic volume index (EDVI) had increased by 33% (p=0.006) and a severe decrease in the load-in- dependent measurement of contractility (PRSW) (-58%; p=0.003). Lower cardiac index (CI) (-28%; p<0.0001), mean arterial pressure (-15%;
p=0.01) and mixed venous oxygen saturation (SvO2) (-36%; p<0.0001) were observed compared to the control group. The interventricular septum deviated towards the left ventricle (LV) (table 1).
Milrinone improved RV-PRSW and CI significantly, maintained systemic pressure and reduced CVP. Incremental doses of epinephrine and dopamine further improved biventricular PRSW and CI equally in a dose-dependent manner. Systemic and pulmonary pressures were higher in the dopamine-treated animals compared to epinephrine-treated animals. None of our treatments improved stroke volume index (SVI) despite significant increases in contractility.
Discussion
Milrinone significantly increased CI and SvO2. These beneficial changes were primarily due to the chronotropic effect. In terms of contractili- ty, no significant difference was found between epinephrine and dopamine in combination with milrinone a part from a higher SVRI and MAP in the dopamine-treated animals. The lack of improvement in SVI was explained by the strong correlations between SVI and LV-EDVI, but not biventricular PRSW (figure 1).
Conclusions
In RVF secondary to PR, milrinone significantly improved CI and SvO2 and increased contractility in the RV. Epinephrine and dopamine had equal inotropic effect, but a greater vasopressor effect was observed for dopamine. SVI was unchanged due to inability of both treatments to increase LV-EDVI.
Abstract N
Korresponderende forfatter Lars Nikolaj Hansen Email Larsniko@dadlnet.dk Afdeling Thoraxanæstesi
Hospital/institution Odense Universitetshospital
Medforfattere Marianne Kjær Jensen, Henrik Scmidt, Jacob Eifer Møller
Titel Kombineret ECMO og impella behandling ved profund kardiogen shock.
Introduktion
Ved manifest kardiogent shock med kritisk reduktion i hjertepumpefunktionen kan det være nødvendigt at supplere inotropibehandling med mekanisk cirkulationsstøtte. Ved biventrikulær hjertesvigt vil dette typisk være i form af af veno-arteriel ekstrakorporal membran Oxygene- ring (VA-ECMO). VA-ECMO kan etableres ved central eller perifer kanylering. Sidstnævnte metode er mindre invasiv men giver modstrøm- sflow fra femoral karrene gennem aorta, hvor der er risiko for dilatation af venstre ventrikel, kompromitteret coronar blodflow og risiko for trombedannelse i venstre ventrikel. Der findes en række metoder til at forebygge dette herunder anvendelse af venstre ventrikel vent, kardiomyotomi[1]og i de senere år har Impella systemet også været foreslået anvendt i kombination med VA-ECMO. Impella systemet (Figur 1) virker via en roterende hydraulisk arkimedesskrue, som kan levere et ikkepulsatilt blodflow på op til 5 l/min. Anvendelsen af Impella har den fordel at VA-ECMO potentielt kan afvikles tidligere, idet denne tilbyder aktiv cirkulations støtte. Nedenstående beskriver single center erfaring med impella CP/5.0 i kombination med VA-ECMO i 5 konsekutive cases.
Cases
I aktuelle hjertecenter anvendtes i 2013 isoleret VA-ECMO i 12 tilfælde.
I 2014 er VA-ECMO til dato anvendt i 7 tilfælde, i 2 tilfælde uden impella anvendelse. I nedenstående 5 cases er anvendelse af VA-ECMO kom- bineret med Impella. 30 dages overlevelse i beskrevne cases er 100% med patienterne udskrevet fra intensivt behandlingsafsnit.
Diskussion
Sygehistorierne illustrerer erfaring med anvendelse af det perkutane impellasystem sammen med perifert etableret VA-ECMO som stabi- lisering af profund kardiogen shock og som bro til recovery. Denne kombination af supportsystemer har den fordel, at man undgår central kanylering sammen med effektiv aflastning af venstre ventrikel [1-2].
Potentielt kan Impella systemet afkorte tiden med behov for VA-ECMO, og dermed mindske risikoen for udvikling af komplikationer som ofte opstår ved længerevarende mekanisk cirkulatonsstøtte med VA-ECMO. Med fordel kan Impella 5.0 systemet anlægges via arteria axillaris, som sikrer en stabil placering af systemet. Mulige komplikationer ved kombinationsanvendelsen er bl.a. udvikling af ”Harlequin” syndrom hos patienter med svær lungesvigt, hvor Impella systemet vil levere dårligt oxygeneret blod til især overkroppen, risiko for mekanisk hæmolyse, og endeligt er det en relativt dyr behandling.
Konklusion
Perifert etableret VA-ECMO i kombination med Impella systemet kan anvendes i tilfælde med svært reduceret venstre ventrikel funktion og perifer kanylering.
Litteratur
1. Rupprecht L, Flörchinger B, Schopka S et al. Cardiac decompression on extracorporal life support: A review and discussion of the litera- ture. ASAIO J 2013; 59:547-553
2. Cheng A, Swartz MF, Massey HT et al. Impella to unload the left ventricle during peripheral extracorporeal membrane oxygenation.
ASAIO J 2013;59:533-6.
3. Castillo-Sang MA, Prasad SM, Singh J et al. Thirty-five day Impella 5.0 support via right axillary side graft cannulation for acute cardioge- nic shock. Innovations (Phila) 2013;8:307-9.
Abstract 22
Korresponderende forfatter Søren Bache
Email bache@dadlnet.dk
Afdeling Department of Neuroanaesthesiology, The Neuroscience Centre Hospital/institution Rigshospitalet
Medforfattere Søren Bache, Rune Rasmussen, Maria Rossing, Niels Risør Hammer, Marianne Juhler, Lennart Friis-Hansen, Finn Cilius Nielsen, Kirsten Møller
Titel Detection and quantification of microRNA in cerebral microdialysate
Introduction
Secondary brain injury accounts for a major part of the morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (SAH), but the pathogenesis and pathophysiology remain controversial.(1) MicroRNAs (miRNAs) are important posttranscriptional regulators of complementary mRNA targets and have been implicated in the pathophysiology of other types of acute brain injury.(2) We hypothesized that miRNAs would be present in human cerebral microdialysate.
Methods
RNA was extracted and real-time quantification PCR of 378 pre-specified miRNAs was performed in:
1) Microdialysate obtained in vitro from four identical samples of cerebrospinal fluid (CSF) from a patient with SAH and four identical undialy- zed reference samples (Fig. 1A); and
2) Microdialysate obtained in vivo at two different time points from two patients with SAH; and CSF obtained by external ventricular drainage in the same two patients at the same time points (Fig. 1B).
Cycle thresholds were set at 0.1, baseline at 3 to 15, and cut-off > 32 cycles. Cycle quantification (Cq) was mean normalized.(3) Results
Of 160 miRNAs detected in CSF, 71 were also found in in vivo microdialysate from SAH patients. Specific miRNAs consistently exhibited either high or low passage through the microdialysis membrane both in vitro and in vivo (Fig. 2). Repeatability analysis showed that the average SD of Cq values in microdialysate was lower than that of CSF (SD for microdialysate, 0.37 (95% CI, 0.33-0.41) vs. SD for CSF, 0.46 (95% CI, 0.41- 0.51) (p = 0.013).
Discussion
To our knowledge, we are the first to quantify miRNAs, important regulators of cell function, in cerebral microdialysate. This is a new appro- ach to address the presence, regulation and roles of miRNAs in the brain of neurocritically ill patients. Moreover, in vivo microdialysis for the study of miRNA may be applied to many other tissues. Because the microdialysis membrane resembles a semi-permeable membrane, the results may also provide information on how miRNAs remain stable in extracellular environments despite the presence of RNases.
Conclusion
MiRNAs are detectable in cerebral microdialysate; a large group of miRNAs consistently shows a high passage through the microdialysis
catheter membrane. Measurement of cerebral interstitial miRNA concentrations may aid in the investigation of secondary brain injury in neurocritical conditions.
Danish Regional Scientific Ethics Committee of the Capital Region approval: #H-3-2013-009 References
1. Rowland MJ et al. Delayed cerebral ischaemia after subarachnoid haemorrhage: looking beyond vasospasm. Br J Anaesth 2012;109:315- 2. Saugstad JA. MicroRNAs as effectors of brain function with roles in ischemia and injury, neuroprotection, and neurodegeneration. J 329.
Cereb Blood Flow Metab 2010;30:1564-1576.
3. Mestdagh P et al. A novel and universal method for microRNA RT-qPCR data normalization. Genome Biol. 2009;10:R64
Abstract 23
Korresponderende forfatter Matias Orre
Email matias.orre@gmail.com
Afdeling Department of Neurointensive Care Hospital/institution Rigshospitalet
Medforfattere Anna Leisner*, Matias Orre*, Søren Bache, Karen-Lise Welling, Vagn Eskesen, Kirsten Møller (*Contributed equally)
Titel Neurointensive care for aneurysmal subarachnoid haemorrhage (aSAH) in Eastern Denmark 2010-2013:
A descriptive study
Introduction
aSAH remains a serious disease with a high mortality and morbidity even after admission to hospital. We studied the course of disease for patients with aSAH admitted to Neurointensive Care Unit (NICU) at Rigshospitalet.
Metods
Patients with SAH were identified by searching the NICU’s patient database (Critical Information System, CIS); diagnoses were cross-validated against the national patient register (Grønt System). Patients with SAH caused by trauma, perimesencephalic bleeds, arteriovenous malfor- mation and pseudoaneurysms were excluded. Data extracted included age, gender, WFNS and Hunt&Hess scales, anatomic localization of the aneurysm, type of treatment (coiling or clipping), length of stay in the NICU, and hospital, ventilator treatment, treatment with sympat- homimetics, occurrence of re-bleeding and delayed cerebral ischaemia (DCI), and survival.
Results
From 1 January 2010, through 31 December 2013, 494 patients (350 females (71%); mean age, 55 (SD, 12) years) were admitted to the NICU with 495 episodes of aSAH. Of these, 430 (87%) underwent clipping (34%), coiling (50%), or both (2.2%); 64 patients (13%) either died before treatment (12%), refused treatment (0.2%), or were treated conservatively because of the small size of the aneurysm (0.4%). Patients stayed in the NICU for a total of 8 (mean; SD, 8; range, 0-48) days; a total of 277 patients (56%) were mechanically ventilated for a total of 8 (mean;
SD, 8; range, 0-37 days). Delayed cerebral ischaemia occurred in 114 patients (23%). One hundred and eleven patients (22%) died during the stay in the NICU.
Discussion
In this population of aSAH patients, the incidence of DCI was a little lower than the approximately 30% reported by others.(1) This could be explained by the implementation of nimodipine as well as the fact that the diagnosis of DCI remains subjective.(1). Our in-hospital mortality, though in the low end, still matches the slowly declining mortality rate described by others. (2)
Conclusion
In a single-center, retrospective study of 494 aSAH patients, we found an incidence of DCI of 23% and a mortality rate of 22% during the stay in the NICU.
References
1. Vergouwen MD, Vermeulen M, van GJ, Rinkel GJ, Wijdicks EF, Muizelaar JP et al. Definition of delayed cerebral ischemia after aneurys- mal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group. Stroke 2010;41:2391-5.
2. Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol 2009;8:635-42.
Abstract G
Korresponderende forfatter Marianne Kjær Jensen
Email marianne.kjaer.jensen@rsyd.dk
Afdeling Anæstesiologisk og Intensiv afdeling V/VITA Hospital/institution Odense Universitetshospital
Titel Langtids-overlevelse og selvvurderet helbred hos patienter behandlet med ekstrakorporal cirkulation på grund af refraktært hjertesvigt
Introduktion
Ekstracorporal cirkulatorisk støtte - Extra corporeal Life Support (ECLS) er en nyere behandlingsmulighed hos patienter med behandlings- refraktært hjertesvigt. Studier og case-reports angiver en overlevelse ved behandling med ECLS på op til 50 %. Kun få studier har belyst langtidsoverlevelse og livskvaliteten efter behandling med ECLS. Combes et al(1) fandt, at langtidsoverlevere rapporterede om vedvarende fysiske og sociale problemer der hæmmede dem i hverdagen. Det selvrapporterede helbred var des bedre jo længere follow-up perioden
varede. I slutningen af 2010 indførtes ECLS til patienter med behandlings refraktært hjertesvigt på intensiv afdeling VITA. Målet for studiet var kvalitetssikring af den nye behandling samt at vurdere de langtidsoverlevede patienters livskvalitet.
Metode
Efter etisk komités accept blev patienter behandlet med ECLS konsekutivt inkluderet fra den 1. januar 2011-til 31. december 2012. Demogra- fiske data, samt data vedrørende overlevelse af ECLS, overlevelse til udskrivelse fra hhv. intensiv terapi afsnit og sygehus samt om patienten var i live pr. 1. juni 2013 blev registreret. Til vurdering af de langtidsoverlevende patienters livskvalitet eller selv vurderede helbredstilstand udsendtes 2 spørgeskemaer et SF 36 helbredskema samt ”hospital anxiety and depression” HAD skema.
Resultater
1532 patienter blev hjerteopererede i denne 2 års periode. Treogtyve patienter blev behandlet med ECLS, på følgende indikationer: 3 patien- ter af medicinske årsager og 20 pga. hjertesvigt efter hjertekirurgi. Demografiske og overlevelses data ses af tabel 1. Den 1. juni 2013 var 9 patienter (39 %) i live. Otte patienter (88 %) returnerede spørgeskemaerne med en median overlevelse på 15 måneder. Resultatet af SF36 ses i tabel 2. Bedømt fra HAD score var der ingen med svær depression eller angst, men 25 % scorede tegn til let angst og 12 % til let depression.
Diskussion
Resultaterne for overlevelse er sammenholdt med data fra Combes gode, med overlevelse efter ECLS på 61% mod 40% og 1 års overlevelse på 39% mod 17%. Forskellen kan ikke forklares umiddelbart, men kan måske tilskrives udvikling indenfor ECLS systemer samt selektion af pa- tienter. De langtidsoverlevende patienters fysiske formåen var mere reduceret end beskrevet af Combes, men med færre psykiske sequelae, hvilket muligvis kan forklares ved at patienterne var ældre.
Konklusion
Patienter behandlet med ECLS for refraktært hjertesvigt havde en overlevelse som er sammenlignelig med andres iagttagelser. Langtidsover- levende patienters selvrapporterede helbredstilstand vurderet ved SF 36 viste en nedsat fysisk formåen og let påvirket psykisk formåen samt ved HADS tegn til let depression og angst. Resultaterne antyder således at langtidsoverlevere evt. kunne drage fordel af målrettet opfølgning for at identificere dem, der kunne få gavn af fysioterapi eller psykologisk assistance.
Referencer
1. Combes, A; Leprince,P; Luyt,CE et al: Crit care med 2008: 36:1404
Abstract 18
Korresponderende forfatter Janus Adler Hyldebrandt Email janus.hyldebrandt@ki.au.dk
Afdeling Departsment of Anaesthesiology and Intensive Care Hospital/institution Aarhus University Hospital
Medforfattere E Sivén, P Agger, CA Frederiksen, J Heiberg, K Wemmelund, HB Ravn.
Titel Effects of Milrinone and Epinephrine or Dopamine on Biventricular Function and Haemodynamics in an Animal Model with Right Ventricular Failure after Pulmonary Artery Banding
Introduction
Right ventricular (RV) failure due to chronic pressure overload is a main determinant of outcome in congenital heart disease. Despite the initi- al compensatory RV hypertrophy, heart failure eventually develops. The medical management under these circumstances is challenging, and recent studies have shown that not only contractility but also the interventricular relationship are important for increasing cardiac output.
The objective of this study was to evaluate the effect of milrinone alone and in combination with incremental doses of epinephrine or dopa- mine on haemodynamics.
Methods
RV hypertrophy was induced in 16 pigs by pulmonary artery banding and compared to 23 healthy controls. Bi-ventricular performance was evaluated by conductance catheters and haemodynamics by pulmonary artery catheter and pressure transducers during milrinone and either incremental epinephrine (0.04, 0.06 and 0.08 µg/kg/min) or dopamine (4, 6 and 8 µg/kg/min) infusions. Effects of the treatments were compared using two-way ANOVA.
Results
After ten weeks, animals were re-examined. The maximum pressure in the RV increased 113% (p<0.0001) and end-diastolic volume by 43%, (p<0.01), while left ventricular maximum pressure simultaneously decreased by 17% (p<0.01). Concomitantly, a decrease in mean arterial pressure (MAP) (-15%, p<0.01), cardiac index (CI) (-20%, p<0.0001) and mixed venous oxygen saturation (SvO2) (-40%, p<0.0001) was obser- ved. The interventricular septum had deviated towards the left ventricle, determined as an increase in the eccentricity index.
Milrinone increased CI (11%, p<0.01) and heart rate (HR) (21%, p<0.0001), but stroke volume index decreased (7%, p<0.05), although RV con- tractility was improved (22%, p<0.05) as judged by preload recruitable stroke work. The addition of either epinephrine or dopamine further increased CI and HR in dose-dependent manners but without any significant differences between the two interventions. A more pronounced increase in biventricular contractility was observed in the dopamine-treated animals. Left ventricular end-diastolic volume decreased signifi- cantly with increasing doses of both inotropes (p<0.05), and the left ventricular eccentricity index further increased (p<0.05) (figure 1).
Conclusions
In conclusion, the present study demonstrates that in RV failure due to pressure overload, milrinone significantly improves cardiac output, with dose-dependent additional effects of both epinephrine and dopamine. Dopamine has a more significant effect on contractility in both the RV and the LV. Despite both combinations of inotropes improved bi-ventricular contractility SVI did not increase due to a further deteri- oration of the interventricular relationship as judged by an increase in the eccentricity index. Additional studies with prolonged observation times are required to confirm these findings.
Poster P
Korresponderende forfatter Sofie Pedersen Email sofie.pedersen@dadlnet.dk
Afdeling Department of cardio-thoracic anaesthesiology and intensive care unit.
Hospital/institution Rigshospitalet.
Medforfattere Roy-Willy Ottestad, Michael Wanscher, Vibeke Lind Jørgensen.
Titel Dexmedetomidine as analgo-sedative agent in adult and paediatric patients at a cardio-thoracic ICU;
a retrospective data analysis
Introduction
Dexmedetomidine (Dexdor®) is a selective alpha-2 adrenoreceptor agonist with sedative and analgesic qualities. It is suitable for light sedati- on of patients in the intensive care unit (ICU) and may in some groups of patients carry advantages in the form of reduced time on ventilator, length of stay, risk of ventricular tachycardia and hyperglycaemia(1,2). Use of dexmedetomidine in Denmark has so far, to our knowledge, been limited, in part due to some of the known side effects; e.g. arrhythmias (mostly bradycardia) and hemodynamic changes (mostly hypo- tension). Furthermore, it remains unclear on which indications and for which patients the drug is more suitable than propofol, and how the treatment may influence the use of other analgesic and sedative agents(3). The purpose of this study was to evaluate the first 18 months of
experiences with dexmedetomidine as a sedative agent in adult and paediatric patients admitted to a cardio-thoracic ICU. Pattern of use is described (single drug or as an add-on), concomitant evolution of daily doses of specific analgesic and sedative agents and adverse effects and events are reported.
Methods
Dexmedetomidine was used at the attending physicians decision and dosed according to a guideline at the department. Patients who were treated were identified retrospectively from a patient data management system (ICIP) that logs types and doses of infusions hour by hour.
Other variables retrieved were pulse, blood pressure, length of stay, time on ventilator and type of surgery. Doses and duration of treatment regarding propofol, midazolam, fentanyl and remifentanil were retrieved from patient data systems (ICIP, EPM). Analysis of doses was perfor- med in 3 increments: ’Before’ (4h before dexmedetomidine infusion), ’during’ (during dexmedetomidine infusion) and ’after’ (the following 24h after dexmedetomidine infusion was stopped) for each drug. Evolution of dose (increased, unchanged, decreased, stopped) of each drug (whether administered as infusion, parenteral or oral route) is reported. Adverse effects and events were retrieved from reco rds.
Material
All cases treated with an infusion of dexmedetomidine in the cardio-thoracic ICU at Rigshospitalet between September 2012 and March 2014. In total 28 paediatric and 111 adult (>16 years) cases were included in the analysis. A few patients were re-admitted and analysed as a new case.
Results
Data are currently being processed and will be presented in full at the annual meeting of DASAIM in November 2014, if accepted.
References
1. Lin YY et al. Can dexmedetomidine be a safe and efficacious sedative agent in post-cardiac surgery patients? A meta-analysis. Crit. care 2012.
2. Tobias JD et al. Dexmedetomidine: Antiarrhythmic effects in the paediatric cardiac patient. Ped. Card. 2013.
3. Reardon DP et al. Role of dexmedetomidine in adults in the intensive care unit: An update. AJHP 2013.
