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Type: Journal article
Title: Emerging benefits and drawbacks of α₂-adrenoceptor agonists in the management of sepsis and critical illness
Other Titles: Emerging benefits and drawbacks of alpha(2)-adrenoceptor agonists in the management of sepsis and critical illness
Author: Lankadeva, Y.R.
Shehabi, Y.
Deane, A.M.
Plummer, M.P.
Bellomo, R.
May, C.N.
Citation: British Journal of Pharmacology, 2021; 178(6):1407-1425
Publisher: Wiley
Issue Date: 2021
ISSN: 0007-1188
Statement of
Yugeesh R. Lankadeva, Yahya Shehabi, Adam M. Deane, Mark P. Plummer, Rinaldo Bellomo, Clive N. May
Abstract: Agonists of α₂ -adrenoceptors are increasingly being used for the provision of comfort, sedation and the management of delirium in critically ill patients, with and without sepsis. In this context, increased sympathetic and inflammatory activity are common pathophysiological features linked to multi-organ dysfunction, particularly in patients with sepsis or those undergoing cardiac surgery requiring cardiopulmonary bypass. Experimental and clinical studies support the notion that the α₂ -adrenoceptor agonists, dexmedetomidine and clonidine, mitigate sympathetic and inflammatory overactivity in sepsis and cardiac surgery requiring cardiopulmonary bypass. These effects can protect vital organs, including the cardiovascular system, kidneys, heart and brain. We review the pharmacodynamic mechanisms by whichα₂-adrenoceptor agonists might mitigate multi-organ dysfunction arising from pathophysiological conditions associated with excessive inflammatory and adrenergic stress in experimental studies. We also outline recent clinical trials that have examined the use of dexmedetomidine in critically ill patients with and without sepsis and in patients undergoing cardiac surgery.
Keywords: cardiac surgery
cardiopulmonary bypass
critical illness
α2-adrenoceptor agonists
Rights: © 2021 The British Pharmacological Society
DOI: 10.1111/bph.15363
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Pharmacology publications

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