Effects of Esketamine Versus Remifentanil on Hemodynamics and Prognosis in Patients with Septic Shock Receiving Invasive Mechanical Ventilation: A Randomized Controlled Trial.

In patients with septic shock on mechanical ventilation, adding esketamine to propofol sedation, compared with adding remifentanil, may reduce the dose of norepinephrine needed to maintain blood pressure. The two sedation regimens produced similar pain scores, and there were no significant differences in heart rate, mean arterial pressure, or 28-day survival. Esketamine appears to be a safe option that helps stabilize hemodynamics in this critically ill population.

Study at a glance

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.