PMID- 28569132
OWN - NLM
STAT- MEDLINE
DCOM- 20200108
LR  - 20220408
IS  - 1525-1489 (Electronic)
IS  - 0885-0666 (Linking)
VI  - 34
IP  - 8
DP  - 2019 Aug
TI  - A Pilot Study of the Use of Dexmedetomidine for the Control of Delirium by 
      Reducing the Serum Concentrations of Brain-Derived Neurotrophic Factor, 
      Neuron-Specific Enolase, and S100B in Polytrauma Patients.
PG  - 674-681
LID - 10.1177/0885066617710643 [doi]
AB  - BACKGROUND: Delirium is very common among patients with polytrauma, although no 
      suitable means exist to feasibly reduce the incidence and duration of delirium in 
      these patients. Recent reports have suggested that continuous intravenous (IV) 
      infusions of dexmedetomidine, rather than benzodiazepine, be administered for 
      sedation to reduce the duration of delirium in this population. However, serum 
      neuron-specific enolase (NSE), S100 calcium binding protein B (S100B), and 
      brain-derived neurotrophic factor (BDNF) levels have not yet been investigated in 
      polytrauma patients who received sedation with dexmedetomidine rather than other 
      conventional sedatives. The aim of this study was to assess the association of 
      blood BDNF, NSE, and S100B with the occurrence of delirium among polytrauma 
      patients who had been sedated with dexmedetomidine. MATERIALS AND METHODS: 
      Consecutive patients were randomly assigned to 1 of 2 treatment study groups, 
      namely the "dexmedetomidine group" or the "common group." This case-control study 
      included 18 patients with delirium and 34 matched controls in a 63-bed general 
      intensive care unit (ICU). Blood samples were collected from all patients upon 
      ICU admission, on the day when delirium was diagnosed, and on days 3 and 5 
      following diagnosis. The serum levels of S100B, BDNF, and NSE were determined by 
      enzyme-linked immunosorbent assay. The sedation levels and delirium were assessed 
      using the Richmond Agitation and Sedation Scale and the Confusion Assessment 
      Method for the ICU. RESULTS: The median BDNF, NSE, and S100B concentrations were 
      significantly lower in the dexmedetomidine group than in the common group on the 
      day when delirium was diagnosed and on the third day after delirium was 
      diagnosed. The rate of delirium was significantly lower in the dexmedetomidine 
      group than in the common group. There were clear differences in the BDNF, NSE, 
      and S100B levels between the 2 groups on the fifth day after delirium was 
      diagnosed. CONCLUSIONS: Our randomized controlled study suggests that the 
      sedation of polytrauma patients with dexmedetomidine could help reduce the serum 
      BDNF, S100B, and NSE levels, which appear to be associated with the occurrence of 
      delirium in the dexmedetomidine group.
FAU - Li, Yong
AU  - Li Y
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Yu, Zhi-Xin
AU  - Yu ZX
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Ji, Mu-Sen
AU  - Ji MS
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Yan, Jun
AU  - Yan J
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Cai, Yan
AU  - Cai Y
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Liu, Jing
AU  - Liu J
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Yang, Hong-Feng
AU  - Yang HF
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
FAU - Jin, Zhao-Chen
AU  - Jin ZC
AD  - 1 Critical Care Medicine Unit, The Affiliated People's Hospital of Jiangsu 
      University, Zhenjiang, Jiangsu, China.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170601
PL  - United States
TA  - J Intensive Care Med
JT  - Journal of intensive care medicine
JID - 8610344
RN  - 0 (Biomarkers)
RN  - 0 (Brain-Derived Neurotrophic Factor)
RN  - 0 (Hypnotics and Sedatives)
RN  - 0 (S100 Calcium Binding Protein beta Subunit)
RN  - 0 (S100B protein, human)
RN  - 67VB76HONO (Dexmedetomidine)
RN  - 7171WSG8A2 (BDNF protein, human)
RN  - EC 4.2.1.11 (Phosphopyruvate Hydratase)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/blood
MH  - Brain-Derived Neurotrophic Factor/*blood
MH  - Delirium/blood/diagnosis/etiology/*prevention & control
MH  - Dexmedetomidine/*therapeutic use
MH  - Female
MH  - Humans
MH  - Hypnotics and Sedatives/*therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multiple Trauma/*complications
MH  - Phosphopyruvate Hydratase/*blood
MH  - Pilot Projects
MH  - Prospective Studies
MH  - S100 Calcium Binding Protein beta Subunit/*blood
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - S100B
OT  - brain-derived neurotrophic factor
OT  - delirium
OT  - dexmedetomidine
OT  - neuron-specific enolase
OT  - polytrauma
EDAT- 2017/06/02 06:00
MHDA- 2020/01/09 06:00
CRDT- 2017/06/02 06:00
PHST- 2017/06/02 06:00 [pubmed]
PHST- 2020/01/09 06:00 [medline]
PHST- 2017/06/02 06:00 [entrez]
AID - 10.1177/0885066617710643 [doi]
PST - ppublish
SO  - J Intensive Care Med. 2019 Aug;34(8):674-681. doi: 10.1177/0885066617710643. Epub 
      2017 Jun 1.