Abstract
BACKGROUND:
Dexmedetomidine is a potentially useful sedative for hospitalized children, but there is little published data regarding its safety, dosage, or efficacy.
OBJECTIVE:
To report our experience with dexmedetomidine for the sedation of hospitalized children.
DESIGN:
Retrospective case series.
SETTING:
Pediatric ICU of a universityโaffiliated children's hospital.
PATIENTS:
We retrospectively examined data from the medical records of all children who received dexmedetomidine for sedation between December 2003 and October 2005.
INTERVENTION:
None.
RESULTS:
Dexmedetomidine was administered 74 times to 60 children (median age 1.5 years, range 0.1โ17.2 years). The most common indications for ICU admission were respiratory distress/failure (53%), statusโpostcorrective cardiac surgery (19%), and other postoperative patients (18%). In 53% of cases dexmedetomidine was used to supplement ongoing sedation judged inadequatem and in 41% of cases it was used as a bridge to extubation while other sedatives were weaned or discontinued. Among all the children, the median dose to maintain adequate sedation was 0.7 ฮผg/kg per hour (range 0.2โ2.5 ฮผg/kg per hour), with a median duration of therapy of 23 hours (range 3โ451 hours). Most children (80%) experienced no adverse effects from the sedation, with hypotension (9%), hypertension (8%), and bradycardia (3%) the most common adverse events. For 93% of children who experienced a side effect, it resolved either without treatment or by withholding the infusion.
CONCLUSIONS:
In this cohort of children hospitalized in the ICU, dexmedetomidine appeared to be effective and to have few adverse effects. Dexmedetomidine may have a potentially useful role to play in sedating hospitalized children. Journal of Hospital Medicine 2008;3:142โ147. ยฉ 2008 Society of Hospital Medicine.