Midazolam and dexmedetomidine sedation impair systolic heart function

Bratisl Lek Listy. 2021;122(6):386-390. doi: 10.4149/10.4149/BLL_2021_064.

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 flow 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 significant 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 filling was not influenced by the sedation technique.

Conclusion: Both sedation regimens worsened the systolic function of both ventricles. Midazolam moreover attenuated early diastolic filling of the left ventricle (Tab. 3, Fig. 4, Ref. 19).

Keywords: cardiac function; cardiac magnetic resonance imaging; dexmedetomidine; midazolam; sedation critical care..

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Arterial Pressure
  • Dexmedetomidine* / adverse effects
  • Heart Rate
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Midazolam* / adverse effects

Substances

  • Hypnotics and Sedatives
  • Dexmedetomidine
  • Midazolam