title: Effect of dexmedetomidine on pulmonary artery pressure after congenital cardiac surgery: A pilot study.
abstract: OBJECTIVE
  To characterize the effects of dexmedetomidine on the pulmonary artery pressure in patients after congenital cardiac surgery.
  
  
  METHODS
  Prospective observational pilot study.
  
  
  METHODS
  Pediatric cardiac intensive care unit at a university hospital.
  
  
  METHODS
  Twenty-two patients who received dexmedetomidine after cardiothoracic surgery.
  
  
  METHODS
  None.
  
  
  RESULTS
  An echocardiogram was performed at three time points: 1) baseline (T0); 2) 6 mins after dexmedetomidine loading (T1); and 3) 1 hr after initiation of dexmedetomidine infusion (T2). Transthoracic echocardiography was used to estimate pulmonary artery pressure based on tricuspid regurgitant velocity (4 x Velocity2) plus central venous pressure. Twenty-two patients aged 0.9 yrs old (interquartile range, 7.9) were enrolled at a median of 1 hr (1.5) after surgery. Dexmedetomidine loading, 0.62 microg/kg (0.5), was given in all patients followed by 0.5 microg/kg/hr (0.6) at T1 and 0.65 microg/kg/hr (0.5) at T2. None of the patients had any increase in pulmonary artery pressure. Overall, the pulmonary artery pressure decreased from 30 mm Hg (13) at T0 to 24 mm Hg (10) at T1 and 26 mm Hg (8) at T2 (p < .001). The pulmonary artery pressure/systemic systolic blood pressure ratio decreased from 33% (12) at T0 to 23% (15) at T1 and 25% (13) at T2 (p = .002). There was no difference in the left ventricular function, Fio2, oxygen %, Po2, CO2, and vasoactive agents.
  
  
  CONCLUSIONS
  Administration of dexmedetomidine after congenital cardiac surgery was not associated with any increase in pulmonary artery pressure.
authors.affiliation: Department of Pediatric Cardiology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Judith P
authors.initials: JP
authors.lastname: Lazol
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lichtenstein
authors.forename: Edmund H
authors.initials: EH
authors.lastname: Jooste
authors.forename: Dana
authors.initials: D
authors.lastname: Shiderly
authors.forename: Nivedit A
authors.initials: NA
authors.lastname: Kudchadker
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Tatum
authors.forename: Richard A
authors.initials: RA
authors.lastname: Orr
authors.forename: Peter D
authors.initials: PD
authors.lastname: Wearden
authors.forename: Victor O
authors.initials: VO
authors.lastname: Morell
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Munoz
authors.forename: Constantinos
authors.initials: C
authors.lastname: Chrysostomou
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000494:pharmacology* / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology* / Q000627:therapeutic use; D007223:Infant; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000187:drug effects* / Q000503:physiopathology
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine