Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Introduction: The high mortality rate observed in sepsis is not only related to the quality of management but it{u2019}s also related to the complex nature of the disease. Loss of autoregulation and altered regional and microvascular blood flow jeopardize both central and peripheral tissue perfusion in septic shock. Ü-2 adrenergic receptor agonists have effects on immunity, inflammation, and coagulation. [7] Also, D. Memis and college[8] suggest that dexmedetomidine may prevent inflammatory effects in sepsis patients during sedation. Methods: All consecutive patients who were clinically suspected of having severe sepsis defined by the criteria of the American college of chest physicians/ society of critical care medicine consensus conference; were included. patients were randomly allocated to two groups (group I: dexmeditomidine) and (group II: midazolam group). Drugs was infused for 6 hours upon admission to intensive care unit (ICU), hemodynamic, central peripheral perfusion variables and microcirculatory variables were simultaneously recorded at baseline and 6 hours after drug infusion. Perfusion variables included; PI, blood lactate level, central venous oxygen saturation (ScVO2), and the difference between central venous carbon dioxide (PcvCO2) and arterial carbon dioxide (PaCO2) pressures (Pv-a CO2

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