Dexmedetomidine versus propofol as a sedative on reduction of intubation rate in patients undergoing noninvasive ventilation in ICU patients

Abstract

Background: Owing to numerous studies, applying sedation during non-invasive breathing technique should be taken into account to lower the percentage of non-invasive ventilation failure and to relax the patient. In order to enhance the effectiveness of non-invasive ventilation, this study will ascertain the efficacy and safety of dexmedetomidine and propofol when used as analgesia-based sedatives in patients.Methods: Ninety adult patients of both sexes with a BMI of below thirty who experienced acute respiratory failure owing to a COPD flare-up or pneumonia with respiratory distress on non-invasive ventilation participated in this prospective randomly controlled clinical study. Patients were randomly assigned to undergo one of two treatments: Group D received dexmedetomidine (0.5 μg/kg/h as a continually IV infusion without an initial bolus, then calibrated each half an hour up until the maximum rate of 1 μg/kg/h, Group P: obtained propofol (rate of 5 μg/kg/min as a constant via IV infusion without a beginning bolus, then titrated by 1.5 μg/kg/min every half an hour up up to the greatest rate of 10.0 μg/kg/min) and Group C (Control group) didn't get any sedative or analgesia.Results: SpO2, PaO2 and SaO2 improved significantly in the two groups D and P with slight improvement in group C (P <0.05). pH showed improvement in both group D and P with little improvement in Group C and significant difference between both groups and group C. PCO2 and HCO3 comparison between the three groups showed decrease in both group D and P with little decrease in group C. Heart rate (HR) and MAP (mean arterial pressure) were substantially distinct between D and P at their lowest levels at 1 hour after sedation, 6 hours, 12 hours, and 24 hours between the two groups, with a considerably greater MAP in the control group at these same time points. Sedation-agitation scale (SAS) and visual analogue scale (VAS) scores decreased substantially in the D and P groups followed dexmedetomidine or propofol administration. With no improvement in SAS and VAS score in control group. But difference between both D group and P group was significant during ongoing infusions via IV of dexmedetomidine or propofol at their lowest doses of effectiveness at 1 hour, six hours, twelve hours, & twenty-four hours.Conclusions: In individuals going through non-invasive ventilation, dexmedetomidine is superior to propofol in terms of sedation and analgesia, yielding than improved outcomes in terms of a reduction in the rate of intubation, ICU immortality, and stay in the hospital.