Document Detail


Prolonged dexmedetomidine infusions in critically ill infants and children.
MedLine Citation:
PMID:  19430081     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To present our institutional experience with prolonged dexmedetomidine (DEX) infusions in critically ill infants and children. DESIGN: Retrospective medical chart review between January 1, 2007 and December 1, 2007. SETTING: Tertiary care pediatric teaching hospital. PARTICIPANTS: Infants and children (up to 18 years of age) who received DEX for a duration greater than 24 hours. MAIN OUTCOME MEASURES: DEX dosing schema and rationale for use. Indices describing DEX efficacy and tolerability including change in patient-specific sedation scores, change in blood pressure and heart rate, and change in conventional analgesia and sedation requirements. RESULTS: Twenty-nine patients (age 5.32 +/- 6.1 y) were evaluated. DEX therapy was initiated at 0.36 +/- 0.16 mcg/kg/hour. One-third of patients received a loading dose (0.5-1 mcg/kg) prior to the start of the infusion. Duration of DEX therapy was 110 +/- 83 hours (range 32-378 hours; median 76 hours). Rationale for adding DEX to sedation regimens included: intent to extubate (n=12), intent to reduce benzodiazepine and opioid use (n=10), exclusive continuous sedation (n=5) and management of drug withdrawal (n=2). Sedation scores remained stable during DEX therapy. Use of conventional analgesia and sedation was generally reduced while receiving DEX. Initiation of therapy was associated with a transient, yet statistically significant reduction in HR (from 120 +/- 28 bpm to 107 +/-N 27 bpm) (P = 0.002), but without a change in blood pressure. CONCLUSIONS: Prolonged DEX infusions were associated with a reduction in concomitant analgesia and sedation medications. DEX was well tolerated with the exception of heart rate, which decreased during the initiation of therapy but may not represent a clinically significant reduction.
Authors:
Pamela D Reiter; Molli Pietras; Emily L Dobyns
Publication Detail:
Type:  Journal Article     Date:  2009-04-01
Journal Detail:
Title:  Indian pediatrics     Volume:  46     ISSN:  0974-7559     ISO Abbreviation:  Indian Pediatr     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-10-08     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  767-73     Citation Subset:  IM    
Affiliation:
Department of Pharmacy, Center for Pediatric Medicine, The Children's Hospital, 13123 East 16th Ave, Denver, USA. reiter.pam@tchden.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Conscious Sedation / methods*
Deep Sedation / methods
Dexmedetomidine / administration & dosage*,  adverse effects
Female
Humans
Hypnotics and Sedatives / administration & dosage*,  adverse effects
Infant
Infusions, Intravenous
Male
Respiration, Artificial
Retrospective Studies
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 113775-47-6/Dexmedetomidine
Comments/Corrections
Comment In:
Indian Pediatr. 2009 Sep;46(9):761-3   [PMID:  19812420 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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