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Báo cáo y học: " Beneficial effects of loxapine on agitation and breathing patterns during weaning from mechanical ventilation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Beneficial effects of loxapine on agitation and breathing patterns during weaning from mechanical ventilation. | Sztrymf et al. Critical Care 2010 14 R86 http ccforum.eom content 14 3 R86 RESEARCH Open Access Beneficial effects of loxapine on agitation and breathing patterns during weaning from mechanical ventilation Benjamin Sztrymf Guillaume Chevrel Fabrice Bertrand Dimitri Margetis Dominique Hurel Jean-Damien Ricard and Didier Dreyfuss Abstract Introduction Interruption of sedation during weaning from mechanical ventilation often leads to patient agitation because of withdrawal syndrome. We tested the short-term efficacy and tolerance of loxapine in this situation. Methods Nineteen mechanically ventilated patients with marked agitation after sedation withdrawal were included. Three agitation scales the Richmond Agitation Sedation Scale RASS the Motor Activity Assessment Scale MAAS and the Ramsay and physiological variables respiratory rate airway occlusion pressure during the first 0.1 second of inspiration P0.1 heart rate and systolic arterial blood pressure were recorded before and after loxapine administration. Results Loxapine dramatically improved all agitation scores RASS and MASS decreased from 2 0 to -1.1 2.3 and 5.4 0.5 to 2.7 1.6 respectively Ramsay increased from 1.0 0 to 3.5 1.5 60 minutes after loxapine administration P 0.05 for all scores as well as P0.1 6 4.2 to 1.8 1.8 cm H2O P 0.05 and respiratory rate from 31.2 7.2 to 23.4 7.8 P 0.05 without hemodynamic adverse events. No side effects occurred. Sixteen 84 patients were successfully managed with loxapine sedation was resumed in two others and one patient self-extubated without having to be reintubated. Conclusions Loxapine was safe and effective in treating agitation in a small group of mechanically ventilated patients and improved respiratory physiologic parameters enabling the weaning process to be pursued. A multicenter trial is under way to confirm these promising results. Introduction ICU patients are constantly exposed to numerous nociceptive stimuli during their ICU stays. Most of them require .