Adjunctive Sedation With Dexmedetomidine for the Prevention of Severe Inflammation and Septic Encephalopathy
Status:
Recruiting
Trial end date:
2022-06-30
Target enrollment:
Participant gender:
Summary
Septic encephalopathy (SE) is defined as acute cerebral dysfunction in patients with sepsis
or septic shock. SE occurs in up to 50% of critically ill patients with sepsis and is
associated with a high mortality and morbidity. The pathophysiology of SE is complex and
involves increased levels of inflammatory mediators such as tumor necrosis factor (TNF)-α,
Interleukin (IL)-1 and IL-6, leading to blood brain barrier dysfunction and neuronal
inflammation. Several biomarkers of neuronal injury have been proposed to identify patients
with SE. Of these biomarkers, S100-β has the highest sensitivity and specificity.
Sedation with Dexmedetomidine (DEX) is a promising strategy for the management of these
patients, as DEX has been shown to decrease the production of inflammatory mediators in
experimental models of sepsis. In clinical studies, DEX lowers the incidence of delirium and
critical illness polyneuropathy. However, its effectiveness in treatment and prevention of SE
remains unclear.
The aim of the present study is to investigate the effect of two standard sedation protocols
(Dexmedetomidine sedation vs. Propofol / Midazolam) on serum markers of SE in critically ill
patients with sepsis who require sedation and mechanical ventilation.