Adverse cardiovascular events are common during dexmedetomidine administration in neonates and infants during intensive care
Tervonen, Miikka; Cajanus, Johanna; Kallio, Merja; Huhtamäki, Heikki; Pokka, Tytti; Peltoniemi, Outi (2023-08-02)
Wiley-Blackwell
02.08.2023
Tervonen, M, Cajanus, J, Kallio, M, Huhtamäki, H, Pokka, T, Peltoniemi, O. Adverse cardiovascular events are common during dexmedetomidine administration in neonates and infants during intensive care. Acta Paediatr. 2023; 112: 2338–2345. https://doi.org/10.1111/apa.16933.
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© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
https://creativecommons.org/licenses/by-nc/4.0/
© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
https://creativecommons.org/licenses/by-nc/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202312073550
https://urn.fi/URN:NBN:fi:oulu-202312073550
Tiivistelmä
Abstract
Aim:
This study aimed to assess the safety of a commonly used sedative, dexmedetomidine in neonates and infants during intensive care.
Methods:
A retrospective cohort study was conducted in the paediatric intensive care unit at Oulu University Hospital. The study population consisted of all children from birth up to 6 months of age who received dexmedetomidine during 2010–2016. Adverse cardiovascular outcomes were defined as abnormal heart rates or blood pressure values according to the Paediatric Early Warning Score.
Results:
Of the 172 infants, 56% had congenital malformation, and 48% had undergone surgery. Neonates and 1–3-month-olds experienced bradycardia (86% vs. 73% in 1–3-month-olds and 50% in 3–6-month-olds, p = 0.001) and severe bradycardia (17% vs. 14% in 1–3-month-olds and 0% in 3–6-month-olds, p = 0.005) more often than older patients. The median maximum rate of dexmedetomidine infusion was 0.86 μg/kg/h (IQR = 0.60–1.71 μg/kg/h). A dose-dependent increase in bradycardia and severe hypotension was found. Adverse cardiovascular events were managed with additional fluid boluses and discontinuation of the infusion.
Conclusion:
Adverse cardiovascular events were common during dexmedetomidine administration in neonates and infants. Lower dexmedetomidine doses may be required in sedating neonates.
Aim:
This study aimed to assess the safety of a commonly used sedative, dexmedetomidine in neonates and infants during intensive care.
Methods:
A retrospective cohort study was conducted in the paediatric intensive care unit at Oulu University Hospital. The study population consisted of all children from birth up to 6 months of age who received dexmedetomidine during 2010–2016. Adverse cardiovascular outcomes were defined as abnormal heart rates or blood pressure values according to the Paediatric Early Warning Score.
Results:
Of the 172 infants, 56% had congenital malformation, and 48% had undergone surgery. Neonates and 1–3-month-olds experienced bradycardia (86% vs. 73% in 1–3-month-olds and 50% in 3–6-month-olds, p = 0.001) and severe bradycardia (17% vs. 14% in 1–3-month-olds and 0% in 3–6-month-olds, p = 0.005) more often than older patients. The median maximum rate of dexmedetomidine infusion was 0.86 μg/kg/h (IQR = 0.60–1.71 μg/kg/h). A dose-dependent increase in bradycardia and severe hypotension was found. Adverse cardiovascular events were managed with additional fluid boluses and discontinuation of the infusion.
Conclusion:
Adverse cardiovascular events were common during dexmedetomidine administration in neonates and infants. Lower dexmedetomidine doses may be required in sedating neonates.
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