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• W2912125011 abstract "Les agonistes alpha-2 adrénergiques (« agonistes alpha-2 ») présentent de multiples effets pharmacodynamiques : sédation dite « éveillable » (rousable sedation), diminution de l’incidence du syndrome confusionnel en réanimation, préservation du contrôle respiratoire (neurogenèse respiratoire), diminution de la consommation d’oxygène, diminution de l’impédance artérielle systémique et pulmonaire, amélioration de la performance systolique et diastolique du ventricule gauche, préservation de la réactivité vasculaire aux catécholamines exogènes, préservation de l’activité baroréflexe vasomotrice avec point de consigne en pression plus faible, fonction rénale préservée, diminution du catabolisme protéique. Ces effets pharmacodynamiques, potentiellement intéressants en réanimation, expliquent l’intérêt porté aux agonistes alpha-2 pour la sédation en réanimation. Toutefois, la place exacte des agonistes alpha-2 en sédation de réanimation reste à déterminer. Compte tenu de la paucité d’essais randomisés multicentriques en double insu, cette analyse, non exhaustive, de la littérature a pour objectif de présenter l’utilisation potentielle des agonistes alpha-2 comme sédatifs de première intention en réanimation. Un protocole d’utilisation de ces molécules est proposé.Alpha-2 adrenergic agonists (“alpha-2 agonists”) present multiple pharmacodynamic effects: rousable sedation, decreased incidence of delirium in the setting of critical care, preservation of respiratory drive, decreased whole body oxygen consumption, decreased systemic and pulmonary arterial impedance, improved left ventricular systolic and diastolic function, preserved vascular reactivity to exogenous catecholamines, preserved vasomotor baroreflex with lowered set point, preserved kidney function, decreased protein catabolism. These pharmacodynamic effects explain the interest for these drugs in the critical care setting. However, their exact role for sedation in critically ill-patients remains open for further studies. Given the few double-blind randomized multicentric trials available, the present non exhaustive analysis of the literature aims at presenting the utilization of alpha-2 agonists as potential first-line sedative agents, in the critical care setting. Suggestions regarding the use of alpha-2 agonists as sedatives are detailed." @default.
• W2912125011 created "2019-02-21" @default.
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• W2912125011 date "1990-01-01" @default.
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• W2912125011 title "Clonidine : du traitement de l'hypertension artérielle à l'utilisation en anesthésie" @default.
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• W2912125011 doi "https://doi.org/10.1016/s0750-7658(05)80949-9" @default.
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