Use of dexmedetomidine for sedation of children hospitalized in the intensive care unit.
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.


METHODS
Retrospective case series.


METHODS
Pediatric ICU of a university-affiliated children's hospital.


METHODS
We retrospectively examined data from the medical records of all children who received dexmedetomidine for sedation between December 2003 and October 2005.


METHODS
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 inadequate 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 microg/kg per hour (range 0.2-2.5 microg/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.
Carroll
Christopher L
CL
Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT 06106, USA. ccarrol@ccmckids.org
Krieger
Diane
D
Campbell
Margaret
M
Fisher
Daniel G
DG
Comeau
Leonard L
LL
Zucker
Aaron R
AR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000494:pharmacology*; D004334:Drug Administration Schedule; D005260:Female; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000494:pharmacology*; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D012189:Retrospective Studies
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine