Effect of dexmedetomidine on pulmonary artery pressure after congenital cardiac surgery: A pilot study.
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.
Lazol
Judith P
JP
Department of Pediatric Cardiology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Lichtenstein
Steven E
SE
Jooste
Edmund H
EH
Shiderly
Dana
D
Kudchadker
Nivedit A
NA
Tatum
Gregory H
GH
Orr
Richard A
RA
Wearden
Peter D
PD
Morell
Victor O
VO
Munoz
Ricardo A
RA
Chrysostomou
Constantinos
C
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
D058647:Adrenergic alpha-2 Receptor Agonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine