DecatSepsis
Trial question
What is the role of dexmedetomidine in patients with septic shock?
Study design
Multi-center
Open label
RCT
Population
90 patients
Inclusion criteria: patients with septic shock and HR > 90 bpm
Key exclusion criteria: pregnancy; severe cardiac dysfunction; history of heart block or patient on pacemaker; severe valvular heart disease; chronic liver disease; traumatic brain injury
Interventions
N=45 dexmedetomidine (at a dose of 0.2-0.7 mcg/kg/hr for 48 hours)
N=45 usual care (usual care without dexmedetomidine infusion)
Primary outcome
Death in hospital
37.8
55.6
55.6 %
41.7 %
27.8 %
13.9 %
0.0 %
Dexmedetomidine
Usual
care
No significant
difference ↔
No significant difference in death in the hospital (37.8% vs. 55.6%; RR 0.68, 95% CI 0.43 to 1.07)
Secondary outcomes
No significant difference in Norepinephrine Equivalent Dose (0.55 mcg/kg/min vs. 0.61 mcg/kg/min; AD -0.06 mcg/kg/min, 95% CI -0.14 to 0.02)
Significant decrease in epinephrine requirement (13.3% vs. 33.3%; RRR 0.6, 95% CI 0.06 to 0.93)
Conclusion
In patients with septic shock and HR > 90 bpm, dexmedetomidine was not superior to usual care with respect to death in the hospital.
Reference
Ahmed Ragab Ezz Al-Regal, Eyad Ahmed Ramzy, Amer Abd Allah Atia et al. Dexmedetomidine for Reducing Mortality in Patients with Septic Shock: A Randomized Controlled Trial (DecatSepsis). Chest. 2024 Jul 12:S0012-3692(24)04601-4.
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