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Dexmedetomidine Use in a Pediatric Intensive Care Unit: A Retrospective Cohort Study

Heidi L Banasch1, Deonne A Dersch-Mills1, Leah L Boulter1

  • 11 Alberta Health Services, Calgary, AB, Canada.

The Annals of Pharmacotherapy
|September 28, 2017
PubMed

Insights

Dexmedetomidine is increasingly used in critically ill children, including those not on mechanical ventilation. While generally well-tolerated, adverse effects were noted in younger patients and with longer infusions, with frequent withdrawal symptoms observed.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pharmacology
  • Intensive Care Unit Management

Background:

  • Increasing use of dexmedetomidine in critically ill pediatric patients.
  • Limited data exists on its effects on mechanical ventilation, sedative use, and adverse events.
  • Need for comprehensive understanding of dexmedetomidine's role in pediatric intensive care.

Purpose of the Study:

  • To describe the utilization patterns of dexmedetomidine in critically ill children.
  • To evaluate the tolerability and safety profile of dexmedetomidine in this population.
  • To assess the impact of dexmedetomidine on mechanical ventilation and concomitant sedative use.

Main Methods:

  • Retrospective cohort study in a pediatric intensive care unit.
  • Inclusion of 219 critically ill pediatric patients receiving dexmedetomidine.
  • Data collection on dexmedetomidine administration, ventilatory support, other sedatives, adverse effects, and withdrawal.

Main Results:

  • Dexmedetomidine used as a first-line sedative in 47.9% of patients, with a median infusion of 27 hours.
  • Significant use in noninvasively ventilated (19.6%) and non-ventilated (35.6%) patients.
  • Adverse effects in 42% of patients, associated with younger age and longer infusion durations; 80% experienced withdrawal symptoms.

Conclusions:

  • Dexmedetomidine is widely used in critically ill children, including non-ventilated and noninvasively ventilated populations.
  • Adverse effects are more common in younger children and with prolonged infusions.
  • High incidence of withdrawal symptoms necessitates careful monitoring and management.
Abstract

Keywords:
childrencritical caredexmedetomidineintensive care unitpediatricsedation

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