Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Impact of selected sedative agents on inflammatory immune response and clinical outcomes in mechanically-ventilated patients with acute exacerbation of chronic obstructive pulmonary disease complicated by sepsis

Weitao Shi^1,2, Jiani Yu³, Xudong Wang¹, Jie Xu¹, Jieqing Yuan⁴, Yuliang Zhao¹

¹Department of Critical Care Medicine, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China; ²Department of Critical Care Medicine, Affiliated Hospital, China University of Mining and Technology, Xuzhou 221000, Jiangsu Province, China; ³Department of Rheumatology and Immunology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China; ⁴Department of Respiratory and Critical Care Medicine, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China.

For correspondence:- Yuliang Zhao Email: ylz6219@163.com

Accepted: 16 May 2024 Published: 30 June 2024

Citation: Shi W, Yu J, Wang X, Xu J, Yuan J, Zhao Y. Impact of selected sedative agents on inflammatory immune response and clinical outcomes in mechanically-ventilated patients with acute exacerbation of chronic obstructive pulmonary disease complicated by sepsis. Trop J Pharm Res 2024; 23(6):985-991 doi: 10.4314/tjpr.v23i6.9

© 2024 The authors.
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Abstract

Purpose: To determine the diverse impact of dexmedetomidine (Dex), propofol (Pro), and midazolam (Mid) sedation on immune response, inflammation, and treatment effects in mechanically-ventilated patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by sepsis.

Methods: 90 patients with AECOPD complicated by sepsis who were undergoing mechanical ventilation in Xuzhou First People's Hospital, China were randomly divided into Pro, Dex and Mid groups, with 30 patients in each group. Prior to the initiation of mechanical ventilation treatment, participants in each group received a slow intravenous injection of 10 - 40 mg of Pro, Dex (1 μg/kg) or Mid (0.05 mg/kg). Throughout the treatment period, each group underwent continuous intravenous infusion, with Pro, Dex and Mid administered at a rate of 0.3 - 4 mg/kg/h; 0.2 - 0.7 μg/kg/h, and 0.02 - 0.1 mg/kg/h, respectively.

Results: On the 6th post-treatment day, concentrations of IL-6, IL-1β, and IL-8 in Pro, Dex and Mid groups were 44.82 ± 25.32, 29.84 ± 26.23, and 43.45 ± 24.57 pg/mL; 12.78 ± 4.48, 9.62 ± 2.28, and 12.19 ± 5.20 pg/mL, and 9.57 ± 3.29, 7.38 ± 2.46, and 10.41 ± 3.66 pg/mL, respectively. The Dex group exhibited significantly lower levels than the pre-treatment levels when compared to others (p < 0.05).

Conclusion: In patients with AECOPD complicated by sepsis, dexmedetomidine sedation effectively mitigates inflammatory response, enhances immune function, improves oxygenation index, enhances lung static compliance, and decreases hospitalization time. Future studies will require a larger sample size drawn from multiracial populations to validate the findings of this report.

Keywords: Dexmedetomidine, Acute exacerbation, Chronic obstructive pulmonary disease, Sepsis, Mechanical ventilation, Inflammatory