{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T09:18:59Z","timestamp":1792833539402,"version":"4.5.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Severe COVID-19 is a life-threatening condition characterized by complications such as interstitial pneumonia, hypoxic respiratory failure, and acute respiratory distress syndrome (ARDS). Non-pharmacological intervention with mechanical ventilation plays a key role in treating COVID-19-related ARDS but is influenced by a high risk of failure in more severe patients. Dexmedetomidine is a new generation highly selective \u03b12-adrenergic receptor (\u03b12-AR) agonist that provides sedative effects with preservation of respiratory function. The aim of this study is to assess how dexmedetomidine influences gas exchange during non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC) in moderate to severe ARDS caused by COVID-19 in a non-intensive care setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a single center retrospective cohort study. We included patients who showed moderate to severe respiratory distress. All included subjects had indication to NIV and were suitable for a non-intensive setting of care. A total of 170 patients were included, divided in a control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200971) and a treatment group (DEX group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200999).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 170 patients were hospitalized for moderate to severe ARDS and COVID-19. The median age was 71\u2009years, 29% females. The median Charlson comorbidity index (CCI) was 2.5. Obesity affected 21% of the study population. The median pO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      was 82\u2009mmHg before treatment. After treatment, the increase of pO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      ratio was clinically and statistically significant in the DEX group compared to the controls (125\u2009mmHg [97\u2013152] versus 94\u2009mmHg [75\u2013122]; ***\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001). A significative reduction of NIV duration was observed in DEX group (10 [7\u201316] days vs. 13 [10\u201317] days; *\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.02). Twenty four patients required IMV in control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200971) and 16 patients in DEX group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200999) with a reduction of endotracheal intubation of 62% (OR 0.38; **\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.008). A higher incidence of sinus bradycardia was observed in the DEX group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Dexmedetomidine provides a \u201ccalm and arousal\u201d status which allows spontaneous ventilation in awake patients treated with NIV and HFNC. The adjunctive therapy with dexmedetomidine is associated with a higher pO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      , lower duration of NIV, and a lower risk of NIV failure. A higher incidence of sinus bradycardia needs to be considered.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2023.1224242","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T16:05:00Z","timestamp":1693497900000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["The role of dexmedetomidine in ARDS: an approach to non-intensive care sedation"],"prefix":"10.3389","volume":"10","author":[{"given":"Francesca","family":"Simioli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Annunziata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Coppola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Imitazione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Irene","family":"Mirizzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Marotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"D\u2019Angelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Fiorentino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"108427","DOI":"10.1016\/j.clim.2020.108427","article-title":"COVID-19 pathophysiology: a review","volume":"215","author":"Yuki","year":"2020","journal-title":"Clin Immunol"},{"key":"ref2","year":""},{"key":"ref3","volume-title":"Underlying medical conditions associated with high risk for severe COVID-19: information for healthcare 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Insights from the LUNG SAFE study","volume":"195","author":"Bellani","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1007\/s00134-021-06459-2","article-title":"Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS","volume":"47","author":"Grieco","year":"2021","journal-title":"Intensive Care Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1224242\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T16:05:02Z","timestamp":1693497902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1224242\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,31]]},"references-count":17,"alternative-id":["10.3389\/fmed.2023.1224242"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1224242","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,31]]},"article-number":"1224242"}}