Organoprotective effects of the α2-adrenoreceptor agonist dexmedetomidine (literature review)

Vitik A.A.1, Shen N.P.2

Tyumen State Medical University, Tyumen

2 The branch of the Tomsk national research medical center “Tyumen Cardiology Research Center”, Tyumen

For correspondence: Shen N.P. — MD, Professor, head of Department of Obstetrics, Gynecology and critical care medicine with a course of KDL of the Institute of Continuing Professional Development of Tyumen State Medical University, Tyumen; e-mail: nataliashen@rambler.ru

For citation: Vitik A.A., Shen N.P. Organoprotective effects of the α2-adrenoreceptor agonist dexmedetomidine (literature review). Alexander Saltanov Intensive Care Herald. 2018;4:74–79.

DOI: 10.21320/1818-474X-2018-4-74-79


Currently, in experimental and clinical studies of critical states, scientists attend to the issues of protecting and preserving the functions of vital organs and systems. The pharmacological aspects of organoprotection with various drugs are considered separately. In this question, α2-adrenoreceptor agonists are of the greatest interest. The study is devoted to the analysis of domestic and foreign literature covering the efficacy of using dexmedetomidine adrenergic mimetic, its mechanisms of action and organ-preventive properties in ECMO patients with organic and mental disorders. Formulated aspects need to study the use of this drug in order to prevent neurocognitive and organ dysfunction in surgical and therapeutic patients who are in intensive care units.

Keywords: organoprotection, dexmedetomidine, α2-adrenoreceptor agonists, multiple organ dysfunction, delirium

Received: 05.10.2018


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Intraoperative hypotension

E.A. Leonova, G.B. Moroz, V.A. Shmyrev, V.V. Lomivorotov

E. Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk

For correspondence: Vladimir Vladimirovich Lomivorotov — MD, PhD, Deputy Director for Research of E. Meshalkin National Medical Research Center; e-mail: vvlom@mail.ru

For citation: Leonova EA, Moroz GB, Shmyrev VA, Lomivorotov VV. Intraoperative hypotension. Alexander Saltanov Intensive Care Herald. 2018;3:87–96.

DOI: 10.21320/1818-474X-2018-3-87-96


The main objective of anesthesiologist is maintenance of patientʼs homeostasis during surgery. Among all the physiological parameters, only arterial pressure has such significant amplitude of oscillations, still the association between postoperative complications and blood pressure fluctuations is often unobvious. Furthermore, blood pressure is a modifiable parameter and can be easily regulated by fluids, vasopressor and inotropic agents in most cases.

Intraoperative decrease of blood pressure may occur due to the action of anesthetics, hypotensive drugs, nonphysiological positioning of the patient on the operating table, artificial ventilation, surgical procedures, cardiopulmonary bypass, hypovolemia, acid-base and electrolyte disorders, acute heart failure, arrhythmias, anaphylaxis and others factors.

The lack of consensus about the definition of hypotension makes difficulties in evaluation of its effect on human organism. More than 140 different absolute and relative values are used as hypotension thresholds. Nevertheless, the data accumulated over the past few years lead us to the conclusion that intraoperative decrease of blood pressure is associated with the development of various nervous, cardiovascular and renal complications, what ultimately leads to increased morbidity and mortality. Severity of adverse effects is a function of range and duration of blood pressure fall.

Every patient has an individual set of genetic, physiological and pathophysiological features that determine the optimal blood pressure level. Thus, another promising direction may be development of the strategy for individualized blood pressure management.

Keywords: blood pressure, hypotension, stroke, delirium, myocardial infarction, acute kidney injury

Received: 24.07.2018


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