Midazolam and dexmedetomidine sedation impair systolic heart function

Abstract

BACKGROUND: Sedation is an essential part of clinical practice. Despite this fact, we still lack data describing the exact impact of sedation on heart function. PURPOSE: To compare the changes in heart function, induced after sedation with either midazolam or dexmedetomidine, using cardiac magnetic resonance imaging (MRI). METHODS: A total number of 30 volunteers were randomized into two groups: 15 participants in the midazolam group (MID) and 15 participants in the dexmedetomidine group (DEX). Every participant underwent a one-session cardiac MRI before and after sedation onset. The following parameters were recorded: left and right ventricle stroke volume (Ao-vol and Pul-vol resp.) and maximum fl ow velocity through the mitral valve during early (E-diast) and late diastole (L-diast). A monitor recorded values of mean blood pressure (MAP), pulse (P) and blood oxygen saturation (SpO2) in 5-minute intervals. RESULTS: Dexmedetomidine led to a statistically signifi cant decrease in Ao-vol (p = 0.006) and Pul-vol (p = 0.003), while midazolam decreased E-diast (p = 0.019) Ao-vol (p = 0.001) and Pul-vol (p = 0.01). The late diastolic fi lling was not infl uenced by the sedation technique. CONCLUSION: Both sedation regimens worsened the systolic function of both ventricles. Midazolam moreover attenuated early diastolic fi lling of the left ventricle (Tab. 3, Fig. 4, Ref. 19). Text in PDF www.elis.sk