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Use of dexmedetomidine for sedation of children hospitalized in the intensive care unit
Author(s) -
Carroll Christopher L.,
Krieger Diane,
Campbell Margaret,
Fisher Daniel G.,
Comeau Leonard L.,
Zucker Aaron R.
Publication year - 2008
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.282
Subject(s) - dexmedetomidine , medicine , sedation , anesthesia , adverse effect , sedative , retrospective cohort study , bradycardia , intensive care unit , pediatric intensive care unit , medical record , pediatrics , surgery , intensive care medicine , heart rate , blood pressure
BACKGROUND: Dexmedetomidine is a potentially useful sedative for hospitalized children, but there is little published data regarding its safety, dosage, or efficacy. OBJECTIVE: To report our experience with dexmedetomidine for the sedation of hospitalized children. DESIGN: Retrospective case series. SETTING: Pediatric ICU of a university‐affiliated children's hospital. PATIENTS: We retrospectively examined data from the medical records of all children who received dexmedetomidine for sedation between December 2003 and October 2005. INTERVENTION: None. RESULTS: Dexmedetomidine was administered 74 times to 60 children (median age 1.5 years, range 0.1–17.2 years). The most common indications for ICU admission were respiratory distress/failure (53%), status–postcorrective cardiac surgery (19%), and other postoperative patients (18%). In 53% of cases dexmedetomidine was used to supplement ongoing sedation judged inadequatem and in 41% of cases it was used as a bridge to extubation while other sedatives were weaned or discontinued. Among all the children, the median dose to maintain adequate sedation was 0.7 μg/kg per hour (range 0.2–2.5 μg/kg per hour), with a median duration of therapy of 23 hours (range 3–451 hours). Most children (80%) experienced no adverse effects from the sedation, with hypotension (9%), hypertension (8%), and bradycardia (3%) the most common adverse events. For 93% of children who experienced a side effect, it resolved either without treatment or by withholding the infusion. CONCLUSIONS: In this cohort of children hospitalized in the ICU, dexmedetomidine appeared to be effective and to have few adverse effects. Dexmedetomidine may have a potentially useful role to play in sedating hospitalized children. Journal of Hospital Medicine 2008;3:142–147. © 2008 Society of Hospital Medicine.