title: High-dose dexmedetomidine-induced hypertension in a child with traumatic brain injury.
abstract: BACKGROUND
  Dexmedetomidine is a centrally acting alpha(2)-adrenergic agonist which is currently FDA-approved for the short-term (less than 24 h) sedation of adults during mechanical ventilation.
  
  
  CONCLUSIONS
  Given its beneficial physiologic properties, there has been increasing use of this agent in the pediatric population. As with any agent used for sedation in the Pediatric ICU setting, dose escalations may be necessary. Unlike benzodiazepines and opioids, there are limited data regarding the administration of dexmedetomidine above the current package insert dosing recommendations of 0.7 microg/kg/h.
  
  
  RESULTS
  We report a 2-year-old child with traumatic brain injury who developed hypertension following the administration of a dexmedetomidine infusion at 4 microg/kg/h for several hours. Investigation into the etiology of the hypertension was negative and the blood pressure returned to baseline with a decrease in the infusion rate.
  
  
  CONCLUSIONS
  Subsequent to this, no further issues with hypertension were noted.
authors.affiliation: Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
authors.forename: Gwen
authors.initials: G
authors.lastname: Erkonen
authors.forename: Fred
authors.initials: F
authors.lastname: Lamb
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D001930:Brain Injuries / Q000628:therapy*; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine