To compare the sedative effect and safety of dexmedetomidine and propofol in patients with severe pneumonia undergoing mechanical ventilation.

A total of 100 patients with severe pneumonia and invasive mechanical ventilation admitted to the Intensive Care Unit (ICU) of the Affiliated People′s Hospital of Jiangsu University from January 2015 to December 2017 were prospectively analyzed. The patients were randomly divided into either a dexmedetomidine group (50 cases) or a propofol group (50 cases). RASS score was maintained at -2 to 0 points. Both groups of patients were given mechanical ventilation bundle therapy and remifentanil analgesia. General clinical data of patients, including gender, age, APACHEⅡ score, and clinical pulmonary infection score (CPIS) were collected. Mean arterial pressure (MAP), heart rate (HR), and spontaneous respiratory rate (RR) before treatment and 15 minutes after the sedation was applied were recorded. The patients′ mechanical ventilation time, extubation time, and ICU stay time were also recorded. The incidence of delirium, ventilator-associated pneumonia (VAP), and 30-day mortality were also collected.

There was no significant difference in gender, age, APACHE Ⅱ score, or CPIS between the two groups (P>0.05). Before sedative administration, there were no significant differences in MAP, HR, or RR (P>0.05). After 15 minutes of treatment, MAP, HR, and RR were all decreased; MAP and RR decreased more significantly in the propofol group, while HR decreased more significantly in the dexmedetomidine group (P<0.01). The mechanical ventilation time, extubation time, and ICU stay were significantly lower in the dexmedetomidine group than in the propofol group (P<0.05). The incidence of delirium was significantly lower in the dexmedetomidine group than in the propofol group (P<0.05), although there were no significant differences in the incidence of VAP or the rate of 30-day mortality between the two groups (P>0.05).

The application of dexmedetomidine in patients with severe pneumonia and mechanical ventilation can reduce the time of mechanical ventilation and ICU stay. Dexmedetomidine is associated with a lower rate of delirium than propofol.