{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:24:10Z","timestamp":1777497850192,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CH"],"published-print":{"date-parts":[[2024,5,18]]},"abstract":"<jats:p>BACKGROUND: Recent studies have shown that dexmedetomidine may improve microcirculation and prevent organ failure. However, most evidence was obtained from experimental animals and patients receiving cardiac surgery with cardiopulmonary bypass. This study aimed to investigate the effect of dexmedetomidine on microcirculation and organ injuries in critically ill general surgical patients. METHODS: In this prospective randomized trial, patients admitted to the surgical intensive care unit after general surgery were enrolled and randomly allocated to the dexmedetomidine or propofol groups. Patients received continuous dexmedetomidine or propofol infusions to meet their requirement of sedation according to their grouping. At each time point, sublingual microcirculation images were obtained using the incident dark field video microscope. RESULTS: Overall, 60 patients finished the trial and were analyzed. Microcirculation parameters did not differ significantly between two groups. Heart rate at 4\u200ah after ICU admission and mean arterial pressures at 12\u200ah and 24\u200ah after ICU admission were lower in the dexmedetomidine group than in the propofol group. At 24\u200ah, serum aspartate aminotransferase (41 (25\u2013118) vs 86 (34\u2013129) U\/L, p\u200a=\u200a0.035) and alanine aminotransferase (50 (26\u2013160) vs 68 (35\u2013172) U\/L, p\u200a=\u200a0.019) levels were significantly lower in the dexmedetomidine group than in the propofol group. CONCLUSION: Microcirculation parameters did not differ significantly between the dexmedetomidine and propofol groups. At 24\u200ah after ICU admission, serum liver enzyme levels were lower in patients receiving dexmedetomidine as compared to propofol.<\/jats:p>","DOI":"10.3233\/ch-232093","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T11:00:58Z","timestamp":1716289258000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of dexmedetomidine versus propofol sedation on microcirculation and organ injuries in critically ill surgical patients: A randomized controlled pilot study"],"prefix":"10.1177","author":[{"given":"Po-Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsing-Hao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wing-Sum","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Far Eastern Memorial Hospital, New Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsung-Ta","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu City, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyun-Han","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Wen","family":"Tien","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Tang","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Chang","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"issue":"1","key":"10.3233\/CH-232093_ref1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1161\/CIRCRESAHA.115.305364","article-title":"The Human Microcirculation: Regulation of Flow and Beyond","volume":"118","author":"Gutterman","year":"2016","journal-title":"Circ Res"},{"issue":"9","key":"10.3233\/CH-232093_ref2","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1097\/01.CCM.0000138558.16257.3F","article-title":"Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock","volume":"32","author":"Sakr","year":"2004","journal-title":"Crit Care Med"},{"issue":"9","key":"10.3233\/CH-232093_ref3","doi-asserted-by":"crossref","first-page":"e889","DOI":"10.1097\/CCM.0000000000003275","article-title":"Microcirculatory Impairment Is Associated With Multiple Organ Dysfunction Following Traumatic Hemorrhagic Shock: The MICROSHOCK Study","volume":"46","author":"Hutchings","year":"2018","journal-title":"Crit Care Med"},{"issue":"3","key":"10.3233\/CH-232093_ref4","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1042\/CS20080069","article-title":"End-organ dysfunction and cardiovascular outcomes: the role of the microcirculation","volume":"116","author":"Lockhart","year":"2009","journal-title":"Clin Sci (Lond)"},{"issue":"1","key":"10.3233\/CH-232093_ref5","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1213\/ANE.0000000000005272","article-title":"Macrocirculation and Microcirculation: The \u201cBatman and Superman\u201d Story of Critical Care Resuscitation","volume":"132","author":"Khanna","year":"2021","journal-title":"Anesth Analg"},{"issue":"Suppl 3","key":"10.3233\/CH-232093_ref6","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1186\/cc14726","article-title":"Hemodynamic coherence and the rationale for monitoring the microcirculation","volume":"19","author":"Ince","year":"2015","journal-title":"Crit Care"},{"issue":"6","key":"10.3233\/CH-232093_ref7","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.bja.2019.07.027","article-title":"Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis","volume":"123","author":"Wang","year":"2019","journal-title":"Br J Anaesth"},{"key":"10.3233\/CH-232093_ref8","doi-asserted-by":"crossref","first-page":"6136105","DOI":"10.1155\/2020\/6136105","article-title":"Organ-Protective Effects and the Underlying Mechanism of Dexmedetomidine","volume":"2020","author":"Bao","year":"2020","journal-title":"Mediators of inflammation"},{"key":"10.3233\/CH-232093_ref9","doi-asserted-by":"crossref","first-page":"107709","DOI":"10.1016\/j.intimp.2021.107709","article-title":"The immunomodulatory mechanism of dexmedetomidine","volume":"97","author":"Yuki","year":"2021","journal-title":"Int Immunopharmacol"},{"issue":"1","key":"10.3233\/CH-232093_ref10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1213\/ANE.0b013e318253631c","article-title":"Dexmedetomidine prevents alterations of intestinal microcirculation that are induced by surgical stress and pain in a novel rat model","volume":"115","author":"Yeh","year":"2012","journal-title":"Anesth Analg"},{"issue":"1","key":"10.3233\/CH-232093_ref11","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1038\/s41598-021-81288-3","article-title":"Effects of dexmedetomidine on renal microcirculation in ischemia\/reperfusion-induced acute kidney injury in rats","volume":"11","author":"Yang","year":"2021","journal-title":"Sci Rep"},{"issue":"2","key":"10.3233\/CH-232093_ref12","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/ALN.0000000000001135","article-title":"Effects of Dexmedetomidine on Intestinal Microcirculation and Intestinal Epithelial Barrier in Endotoxemic Rats","volume":"125","author":"Yeh","year":"2016","journal-title":"Anesthesiology"},{"issue":"2","key":"10.3233\/CH-232093_ref13","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1053\/j.jvca.2018.06.016","article-title":"Effect of Dexmedetomidine Infusion on Sublingual Microcirculation in Patients Undergoing On-Pump Coronary Artery Bypass Graft Surgery: A Prospective Randomized Trial","volume":"33","author":"Mohamed","year":"2019","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"6","key":"10.3233\/CH-232093_ref14","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1053\/j.jvca.2016.05.038","article-title":"Dexmedetomidine Versus Propofol Sedation Improves Sublingual Microcirculation After Cardiac Surgery: A Randomized Controlled Trial","volume":"30","author":"Liu","year":"2016","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"1","key":"10.3233\/CH-232093_ref15","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1741-7015-8-18","article-title":"CONSORT Statement: updated guidelines for reporting parallel group randomised trials","volume":"8","author":"Schulz","year":"2010","journal-title":"BMC Medicine"},{"issue":"5","key":"10.3233\/CH-232093_ref16","doi-asserted-by":"crossref","first-page":"R257","DOI":"10.1186\/cc10518","article-title":"Pharmacokinetics of prolonged infusion of high-dose dexmedetomidine in critically ill patients","volume":"15","author":"Iirola","year":"2011","journal-title":"Crit Care"},{"issue":"1","key":"10.3233\/CH-232093_ref17","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1038\/s41598-018-37975-9","article-title":"Endocan as a marker of microvascular inflammation in kidney transplant recipients","volume":"9","author":"Lee","year":"2019","journal-title":"Sci Rep"},{"issue":"6","key":"10.3233\/CH-232093_ref18","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1053\/j.ajkd.2009.07.020","article-title":"Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis","volume":"54","author":"Haase","year":"2009","journal-title":"Am J Kidney Dis"},{"issue":"2","key":"10.3233\/CH-232093_ref19","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/s00795-013-0055-7","article-title":"Diamine oxidase as a marker of intestinal mucosal injury and the effect of soluble dietary fiber on gastrointestinal tract toxicity after intravenous 5-fluorouracil treatment in rats","volume":"47","author":"Fukudome","year":"2014","journal-title":"Med Mol Morphol"},{"issue":"5","key":"10.3233\/CH-232093_ref20","doi-asserted-by":"crossref","first-page":"R101","DOI":"10.1186\/cc6118","article-title":"How to evaluate the microcirculation: report of a round table conference","volume":"11","author":"De Backer","year":"2007","journal-title":"Crit Care"},{"issue":"1","key":"10.3233\/CH-232093_ref21","first-page":"31","article-title":"Dexmedetomidine Attenuates Renal and Myocardial Ischemia\/Reperfusion Injury in a Dose-Dependent Manner by Inhibiting Inflammatory Response","volume":"49","author":"Xu","year":"2019","journal-title":"Ann Clin Lab Sci"},{"issue":"3","key":"10.3233\/CH-232093_ref22","first-page":"271","article-title":"Dose-related effects of dexmedetomidine on sepsis-initiated lung injury in rats","volume":"71","author":"Karabulut","year":"2021","journal-title":"Brazilian journal of anesthesiology"},{"issue":"5","key":"10.3233\/CH-232093_ref23","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1093\/bja\/87.5.684","article-title":"Comparison between dexmedetomidine and propofol for sedation in the intensive care unit: patient and clinician perceptions","volume":"87","author":"Venn","year":"2001","journal-title":"Br J Anaesth"},{"issue":"5","key":"10.3233\/CH-232093_ref24","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1001\/jama.2009.56","article-title":"Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial","volume":"301","author":"Riker","year":"2009","journal-title":"JAMA"},{"issue":"10","key":"10.3233\/CH-232093_ref25","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s40265-015-0419-5","article-title":"Dexmedetomidine: A Review of Its Use for Sedation in the Intensive Care Setting","volume":"75","author":"Keating","year":"2015","journal-title":"Drugs"},{"issue":"2","key":"10.3233\/CH-232093_ref26","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/00000542-200008000-00016","article-title":"The effects of increasing plasma concentrations of dexmedetomidine in humans","volume":"93","author":"Ebert","year":"2000","journal-title":"Anesthesiology"},{"key":"10.3233\/CH-232093_ref27","doi-asserted-by":"crossref","unstructured":"Weerink MA , Struys MM , Hannivoort LN , Barends CR , Absalom AR , Colin P . Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine. Clin Pharmacokinet 2017.","DOI":"10.1007\/s40262-017-0507-7"},{"key":"10.3233\/CH-232093_ref28","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.jss.2018.03.040","article-title":"Comparison of dexmedetomidine versus propofol on hemodynamics in surgical critically ill patients","volume":"228","author":"Chang","year":"2018","journal-title":"J Surg Res"},{"issue":"2","key":"10.3233\/CH-232093_ref29","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.jss.2013.07.006","article-title":"The effects of propofol and dexmedetomidine infusion on fluid responsiveness in critically ill patients","volume":"185","author":"Yu","year":"2013","journal-title":"J Surg Res"},{"issue":"6","key":"10.3233\/CH-232093_ref30","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1213\/00000539-199612000-00005","article-title":"The effect of dexmedetomidine on nutrient organ blood flow","volume":"83","author":"Lawrence","year":"1996","journal-title":"Anesth Analg"},{"issue":"12","key":"10.3233\/CH-232093_ref31","doi-asserted-by":"crossref","first-page":"793","DOI":"10.21037\/atm.2020.03.222","article-title":"Assessment of sublingual microcirculation in critically ill patients: consensus and debate","volume":"8","author":"Dilken","year":"2020","journal-title":"Ann Transl Med"},{"issue":"10","key":"10.3233\/CH-232093_ref32","doi-asserted-by":"crossref","first-page":"2754","DOI":"10.1053\/j.jvca.2019.10.038","article-title":"Monitoring of the Sublingual Microcirculation During Cardiac Surgery: Current Knowledge and Future Directions","volume":"34","author":"Flick","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"5","key":"10.3233\/CH-232093_ref33","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/anae.14577","article-title":"Postoperative microcirculatory perfusion and endothelial glycocalyx shedding following cardiac surgery with cardiopulmonary bypass","volume":"74","author":"Dekker","year":"2019","journal-title":"Anaesthesia"},{"issue":"6","key":"10.3233\/CH-232093_ref34","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1093\/bja\/aeu132","article-title":"Dexmedetomidine reduces intestinal and hepatic injury after hepatectomy with inflow occlusion under general anaesthesia: a randomized controlled trial","volume":"112","author":"Wang","year":"2014","journal-title":"Br J Anaesth"},{"issue":"5","key":"10.3233\/CH-232093_ref35","first-page":"1007","article-title":"Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium","volume":"80","author":"Leslie","year":"1995","journal-title":"Anesth Analg"},{"key":"10.3233\/CH-232093_ref36","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jclinane.2017.03.053","article-title":"The effect of dexmedetomidine on renal function in patients undergoing cardiac valve replacement under cardiopulmonary bypass: A double-blind randomized controlled trial","volume":"40","author":"Zhai","year":"2017","journal-title":"J Clin Anesth"},{"issue":"2","key":"10.3233\/CH-232093_ref37","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1093\/icvts\/ivu367","article-title":"The dose-related effects of Dexmedetomidine on renal functions and serum neutrophil gelatinase-associated lipocalin values after coronary artery bypass grafting: a randomized, triple-blind, placebo-controlled study","volume":"20","author":"Balkanay","year":"2015","journal-title":"Interactive Cardiovascular and Thoracic Surgery"},{"key":"10.3233\/CH-232093_ref38","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.jss.2021.06.043","article-title":"Effects of Dexmedetomidine on Patients Undergoing Laparoscopic Surgery for Colorectal Cancer","volume":"267","author":"Sun","year":"2021","journal-title":"J Surg Res"},{"issue":"29","key":"10.3233\/CH-232093_ref39","doi-asserted-by":"crossref","first-page":"e4295","DOI":"10.1097\/MD.0000000000004295","article-title":"Dexmedetomidine improves gastrointestinal motility after laparoscopic resection of colorectal cancer: A randomized clinical trial","volume":"95","author":"Chen","year":"2016","journal-title":"Medicine"},{"issue":"5","key":"10.3233\/CH-232093_ref40","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1097\/ALN.0b013e3182503964","article-title":"Dexmedetomidine administration before, but not after, ischemia attenuates intestinal injury induced by intestinal ischemia-reperfusion in rats","volume":"116","author":"Zhang","year":"2012","journal-title":"Anesthesiology"},{"issue":"1","key":"10.3233\/CH-232093_ref41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/CH-2010-1281","article-title":"Effect of mechanical ventilation on microvascular perfusion in critical care patients","volume":"45","author":"Lauten","year":"2010","journal-title":"Clin Hemorheol Microcirc"},{"issue":"3","key":"10.3233\/CH-232093_ref42","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.bjan.2017.02.002","article-title":"[Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome]","volume":"67","author":"Nunes","year":"2017","journal-title":"Rev Bras Anestesiol"}],"container-title":["Clinical Hemorheology and Microcirculation"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/CH-232093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:07:01Z","timestamp":1777388821000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.medra.org\/servlet\/aliasResolver?alias=iospress&doi=10.3233\/CH-232093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,18]]},"references-count":42,"URL":"https:\/\/doi.org\/10.3233\/ch-232093","relation":{},"ISSN":["1386-0291","1875-8622"],"issn-type":[{"value":"1386-0291","type":"print"},{"value":"1875-8622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,18]]}}}