| 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 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| 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
Previous Document: Ketogenic diet in Indian children with uncontrolled epilepsy.
Next Document: Physical Work Capacity of Young Underprivileged School Girls: Impact of Daily vs Intermittent Iron-F...