title: Dexmedetomidine sedation leading to refractory cardiogenic shock.
abstract: Dexmedetomidine is frequently used for deep sedation during electrophysiology procedures. We report a case where, presumably, the use of dexmedetomidine resulted in a patient's death. The patient developed unexplained and refractory cardiogenic shock and could not be resuscitated. Autopsy failed to demonstrate any abnormality or cause of death. We postulate that, in certain susceptible individuals, dexmedetomidine may lead to terminal complications. We therefore urge caution about using dexmedetomidine in the electrophysiology laboratory.
authors.affiliation: St. Luke's-Roosevelt Hospital Center/Columbia University, 1111, Amsterdam Ave., New York City, NY 10025, USA. Tina.sichrovsky@gmx.net
authors.forename: Tina C
authors.initials: TC
authors.lastname: Sichrovsky
authors.forename: Suneet
authors.initials: S
authors.lastname: Mittal
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Steinberg
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology; D001344:Autopsy; D016887:Cardiopulmonary Resuscitation; D020927:Dexmedetomidine / Q000009:adverse effects*; D022062:Electrophysiologic Techniques, Cardiac; D017809:Fatal Outcome; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D017211:Treatment Failure
chemical_list: D000316:Adrenergic alpha-Agonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine