Evaluation of the effects of dexmedetomidine infusion on oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease

BMC Anesthesiol. 2018 Aug 14;18(1):104. doi: 10.1186/s12871-018-0572-y.

Abstract

Background: Dexmedetomidine infusion improves oxygenation and lung mechanics in patients with chronic obstructive lung disease; however, its effect in patients with restrictive lung disease has not been thoroughly investigated yet. The aim of this work was to evaluate the effects of dexmedetomidine infusion on oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease.

Methods: Forty-two morbidly obese patients scheduled for bariatric surgery were included in the study. Patients were randomized to receive either dexmedetomidine infusion at a bolus dose of 1mcg/Kg followed by infusion at 1 mcg/Kg/hour for 90 min (Dexmedetomidine group), or normal saline infusion (Control group). Both groups were compared with regard to: oxygenation {P/F ratio: PaO2/fraction of inspired oxygen (FiO2)}, lung compliance, dead space, plateau pressure, blood pressure, and heart rate.

Results: Dexmedetomidine group showed significant improvement of the PaO2/FiO2 ratio, and higher lung compliance compared to control group by the end of drug infusion. Dexmedetomidine group demonstrated decreased dead space, plateau pressure, blood pressure, and heart rate compared to control group by the end of drug infusion.

Conclusion: A 90-min dexmedetomidine infusion resulted in moderate improvement in oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease.

Trial registration: clinicaltrials.gov : NCT02843698 on 20 July 2016.

Keywords: Dexmedetomidine; Morbidly obese; Oxygenation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bariatric Surgery / methods
  • Dexmedetomidine / administration & dosage
  • Dexmedetomidine / pharmacology*
  • Double-Blind Method
  • Female
  • Hemodynamics / physiology
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / pharmacology
  • Hypnotics and Sedatives / therapeutic use
  • Infusions, Intravenous
  • Lung / drug effects*
  • Lung / metabolism*
  • Lung / physiopathology
  • Male
  • Obesity, Morbid / complications
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery
  • Oxygen / metabolism*
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Young Adult

Substances

  • Hypnotics and Sedatives
  • Dexmedetomidine
  • Oxygen

Associated data

  • ClinicalTrials.gov/NCT02843698