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Delirio posquirúrgico complicado con sepsis. Dexmedetomidina contra midazolam

Felipe de Jesús Martín Pérez-Rada, María Teresa Macías-García, Alicia Concepción Cataneo-Cerna

Resumen


Objetivo: determinar el delirio provocado por dos sedantes.

Métodos: estudio observacional, analítico, comparativo, prospectivo y longitudinal, de 59 adultos con ventilación mecánica, sépticos, sedados con dexmedetomidina o midazolam. Se evaluó edad, sexo, SOFA, APACHE, sepsis o choque séptico, función renal, delirio, días de ventilación mecánica y de estancia hospitalaria, reintubaciones y efectos adversos de los fármacos. Se usó t de Student y χ2.

Resultados: 33 pacientes con midazolam y 26 con dexmedetomi-dina. Con midazolam: edad 49.75 ± 19.48 años, puntuación SOFA y APACHE 7.51 ± 5.41 y 15.81 ± 7.48, delirio en 29 pacientes, 15.86 ± 14.12 días de ventilación mecánica, 24 % reintubado, 16.41 ± 14.41 días en la unidad de cuidados intensivos (UCI), 28.58 ± 19.91 días de estancia hospitalaria, 34.5 % falleció. Con dexmedeto-midina: edad 49.57 ± 13.76, puntuación SOFA y APACHE 6.23 ± 4.51 y 13.34 ± 7.66, delirio en 11 pacientes, 17.9 ± 12.53 días de ventilación mecánica, 45.5 % reintubado, 14.36 ± 9.25 días en la UCI, 22.63 ± 14.87 días de estancia hospitalaria, 36.4 % falleció.

Conclusiones: los pacientes posquirúrgicos con sepsis sometidos a ventilación mecánica presentan más delirio con midazolam.


Palabras clave


Delirio; Dexmedetomidina; Midazolam

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Referencias


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