Because of its analgesic and light sedative properties, the highly selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) has been suggested for the treatment of septic patients, but its effect on the duration of mechanical ventilation remains unclear. The present study was conducted to review the extant literature in DEX and determine its influence on ventilation time in adult septic patients. Databases of PubMed, Cochrane, and EMBASE were applied till 20th January 2019 without language restriction. The searching strategy as following: sepsis OR septic AND mechanical ventilation AND dexmedetomidine. Two authors screened titles, abstracts, and even articles to meet the including criterion independently. In addition, references of related articles or reviews were also referred. Data was recorded in a table and analyzed using the software of Review Manager 5.0. Four studies with a total of 349 patients were included. Three trials with 267 patients revealed the effect of DEX on duration of mechanical ventilation, two trials with 264 patients on ventilator-free days and four trials with 334 patients on 28-day mortality. The analyzed results indicated that DEX was not associated with significantly different durations of mechanical ventilation (MD 0.65, 95% CI, − 0.13 to 1.42, P = 0.10). However, there were significant differences in ventilator-free days (MD 3.57, 95% CI, 0.26 to 6.89, P = 0.03) and 28-day mortality (RR 0.61, 95% CI, 0.49 to 0.94, P = 0.02) in the septic patients. Administration of DEX for sedation in septic patients was not associated with the duration of mechanical ventilation, but it increased the ventilator-free days and reduced 28-day mortality.

中文翻译：

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右美托咪定对脓毒症患者机械通气持续时间的影响：系统评价和荟萃分析

由于其镇痛和轻度镇静特性，高选择性 α-2 肾上腺素能受体激动剂右美托咪定 (DEX) 已被建议用于治疗脓毒症患者，但其对机械通气持续时间的影响尚不清楚。本研究旨在回顾 DEX 中的现有文献，并确定其对成人脓毒症患者通气时间的影响。PubMed、Cochrane 和 EMBASE 的数据库应用到 2019 年 1 月 20 日，没有语言限制。检索策略如下：脓毒症 OR 脓毒症 AND 机械通气 AND 右美托咪定。两位作者独立筛选标题、摘要甚至文章以满足纳入标准。此外，还参考了相关文章或评论的参考。数据记录在表格中，并使用 Review Manager 5.0 软件进行分析。共纳入 4 项研究，共 349 名患者。三项涉及 267 名患者的试验揭示了 DEX 对机械通气持续时间的影响，两项涉及 264 名患者的无呼吸机天数和四项涉及 334 名患者的 28 天死亡率的试验。分析结果表明 DEX 与显着不同的机械通气持续时间无关（MD 0.65，95% CI，- 0.13 至 1.42，P = 0.10）。然而，在无呼吸机天数（MD 3.57，95% CI，0.26 至 6.89，P = 0.03）和 28 天死亡率（RR 0.61，95% CI，0.49 至 0.94，P = 0.02）方面存在显着差异。脓毒症患者。在脓毒症患者中使用 DEX 进行镇静与机械通气的持续时间无关，