Effects of Esketamine Versus Remifentanil on Hemodynamics and Prognosis in Patients with Septic Shock Receiving Invasive Mechanical Ventilation: A Randomized Controlled Trial.
Drug design, development and therapy – January 01, 2025
Source: PubMed
Summary
In treating critically ill patients with septic shock, the choice of sedation can significantly impact recovery. New findings show esketamine requires less blood pressure support than traditional options. When combined with propofol, esketamine reduced the need for norepinephrine by 58% compared to remifentanil in patients on invasive mechanical ventilation, while maintaining similar safety and survival rates.
Abstract
Analgesics and sedatives may affect the hemodynamics of patients with septic shock and produce adverse reactions. The purpose of this study is to compare the hemodynamic effects and prognosis of esketamine and remifentanil in combination with propofol in patients with septic shock receiving invasive mechanical ventilation. In this single-center, prospective, randomized, controlled pilot study, patients with septic shock in the intensive care unit (ICU) receiving invasive mechanical ventilation were randomized to receive esketamine or remifentanil in combination with propofol intravenously. The target Critical-Care Pain Observation Tool (CPOT) score was 0.05). Kaplan-Meier survival analysis showed that there was no significant difference in 28-day survival rate between the two groups(P=0.225). Esketamine may decrease the dosage of norepinephrine in patients with septic shock receiving invasive mechanical ventilation. It is beneficial for stabilizing hemodynamics and appears to be an effective and safe agent for patients with septic shock requiring invasive mechanical ventilation.