Influence of Sedation with Dexmedetomidine on Oxidative Distress During Delirium Developed Following Severe Polytrauma

Abstract

Purpose is to evaluate the influence of intravenous sedation with dexmedetomidine and propofol on the intensity of oxidative distress, delirium severity and duration in severe polytrauma patients.Material and methods. 100 victims (18 to 50 years of age, trauma of two regions and more, ISS score at admission equal to 16–50) were included in the study. Depending on sedation method, the patients were split into group I (n=51) and group II (n=49), in the combined therapy of whom propofol and dexmedetomidine were used, respectively. In addition to standard examinations, the blood plasma carbonylated peptides were assayed in all patients.Results. It has been established that the assay content of carbonylated peptides in blood might reflect polytrauma severity. A link between the oxidative distress intensity and delirium duration (r=0.34; P<0.05) and severity (r=0.38, P<0.05) in severe polytrauma patients has been demonstrated, which might support the role of oxidative distress in delirium development. Influence of the sedation drugs dexmedetomidine or propofol on oxidative distress intensity was not evident in all stages of the study.Conclusion. Significant oxidative distress promotes longer and more severe course of delirium in severe polytrauma patients. The content of carbonylated proteins over 0.78 nmol/mg predicts the development of cognitive dysfunction one month after severe polytrauma with 62% sensitivity and 67% specificity. In spite of clinical efficacy, neither dexmedetomidine nor propofol reliably reduce oxidative distress in severe polytrauma patients.