Open AccessDexmedetomidine Pharmacokinetics and a New Dosing Paradigm in Infants Supported With Cardiopulmonary Bypass
Author(s) -
Kanecia O. Zimmerman,
Huali Wu,
Matthew M. Laughon,
Rachel G. Greenberg,
Richard Walczak,
Scott R. Schulman,
Patrick B. Smith,
Christoph P. Hornik,
Michael CohenWolkowiez,
Kevin M. Watt
Publication year - 2019
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0000000000003700
Subject(s) - dexmedetomidine , medicine , anesthesia , dosing , sedation , cardiopulmonary bypass , bradycardia , cardiac surgery , intensive care , intensive care medicine , surgery , heart rate , blood pressure
Dexmedetomidine is increasingly used off-label in infants and children with cardiac disease during cardiopulmonary bypass (CPB) and in the postoperative period. Despite its frequent use, optimal dosing of dexmedetomidine in the setting of CPB has not been identified but is expected to differ from dosing in those not supported with CPB. This study had the following aims: (1) characterize the effect of CPB on dexmedetomidine clearance (CL) and volume of distribution (V) in infants and young children; (2) characterize tolerance and sedation in patients receiving dexmedetomidine; and (3) identify preliminary dosing recommendations for infants and children undergoing CPB. We hypothesized that CL would decrease, and V would increase during CPB compared to pre- or post-CPB states.