Abstract

This study evaluated the effects of different dexmedetomidine doses on respiratory mechanics and safety indicators in intensive care unit patients undergoing centralized mechanical ventilation. Intensive care unit patients receiving mechanical ventilation from January 2016 to December 2022 were divided into dexmedetomidine-A, dexmedetomidine-B, midazolam and propofol groups. Dexmedetomidine-A received dexmedetomidine at 0.6 μg/kg/h and dexmedetomidine-B at 1.0 μg/kg/h. Respiratory mechanics and safety parameters were compared. Dexmedetomidine-A and dexmedetomidine-B groups showed no significant changes in volume, respiratory rate, minute ventilation, partial pressure of carbon dioxide in expired tidal and forced expiratory volume percentage compared to baseline (T0) at T1-T6 (p>0.05). In midazolam and propofol groups, significant changes were observed in volume, respiratory rate, minute ventilation at T1- T6, partial pressure of carbon dioxide in expired tidal at T1-T4 and forced expiratory volume percentage at T3-T6 compared to T0 (p<0.05). Differences between dexmedetomidine-A/dexmedetomidine-B and midazolam/propofol groups were statistically significant (p<0.05), but not between dexmedetomidine-A/ dexmedetomidine-B groups (p>0.05). Other parameters such as partial pressure of carbon dioxide, heart rate, medication dosage, Ramsay score, Richmond agitation sedation scale score, time to achieve target Richmond agitation sedation scale, duration of ventilation and intensive care unit stay varied significantly among groups. Dexmedetomidine has less impact on respiratory mechanics compared to midazolam and propofol in intensive care unit patients undergoing centralized mechanical ventilation. Both 0.6 μg/kg/h and 1.0 μg/kg/h dexmedetomidine doses provide equivalent sedation and safety benefits.