Risk Factors for the Development of Dexmedetomidine-Related Fevers in Critically-Ill Patients

Area of Science:

• Critical Care Medicine
• Pharmacology
• Clinical Practice Guidelines

Background:

• The Society of Critical Care Medicine recommends dexmedetomidine for sedation in critically-ill, mechanically ventilated patients.
• Fever is a reported side effect of dexmedetomidine, often a diagnosis of exclusion.
• Misdiagnosis of drug-induced fever can lead to increased resource utilization.

Purpose of the Study:

• To identify risk factors for dexmedetomidine-related fever in critically-ill patients.
• To improve recognition and management of dexmedetomidine-induced fever.
• To inform clinical practice regarding dexmedetomidine use.

Main Methods:

• Single-center retrospective study at The Brooklyn Hospital Center.
• Included adult ICU patients receiving continuous dexmedetomidine infusion for ≥12 hours.
• Used univariate and multivariate logistic regression to identify risk factors.

Main Results:

• 38.3% of 81 patients developed fever during dexmedetomidine infusion.
• Continuous dexmedetomidine infusion for ≥72 hours increased fever risk (OR 5.97).
• Dexmedetomidine infusion rate ≥1 mcg/kg/hr at Tmax increased fever risk (OR 6.16).

Conclusions:

• Prolonged dexmedetomidine infusion (≥72 hours) is a risk factor for fever.
• Higher dexmedetomidine infusion rates (≥1 mcg/kg/hr) are associated with fever.
• These findings aid in identifying patients at risk for dexmedetomidine-related fever.