Cardiorespiratory Stability in Critically Ill Preterm Infants following Dexmedetomidine Initiation

This study aimed to evaluate cardiorespiratory status in preterm infants receiving dexmedetomidine using high-resolution physiologic data.We analyzed preterm infants with continuous heart rate (HR) and oxygen saturation (SpO₂) data for 24 hours preceding and 48 hours following dexmedetomidine initiation. Invasive arterial blood pressure (ABP), when available, was analyzed.In 100 infants with a mean gestational age of 28 weeks and high baseline illness severity, mean HR decreased from 152 to 141 beats per minute while mean SpO₂ increased from 91 to 93% in the 48 hours after dexmedetomidine initiation (p < 0.01). In 57 infants with continuous ABP monitoring, mean ABP increased from 40 to 42 mm Hg (p = 0.01). Vasoactive-inotropic support increased before and after initiation.We observed cardiorespiratory changes in critically ill preterm infants following dexmedetomidine initiation; mean HR decreased and mean SpO₂ increased in the 48 hours after initiation. In a subset, mean ABP increased along with vasoactive-inotropic support. · Limited evidence exists on the acute cardiorespiratory effects of dexmedetomidine in preterm infants.. · Evaluation of continuous HR, blood pressure, and oxygenation from two centers provides useful data.. · Dexmedetomidine consistently decreased the HR of preterm infants.. · Dexmedetomidine initiation during critical illness complicated the interpretation of physiologic effects.. · Oxygenation stabilized after initiation during invasive mechanical ventilation..