• Users Online: 16
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 3  |  Page : 107-115

Effects of two dosing cohorts of dexmedetomidine as a primary sedative in critically ill infants with respiratory failure


1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, Egypt
2 Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Hala S Abdel-Ghaffar
Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AJOP.AJOP_5_20

Rights and Permissions

Background Despite being increasingly used, prospective randomized dose-finding studies on dexmedetomidine (DEX) sedation in infants are deficient. Aim The aim was to compare the efficacy of two fixed dosing cohorts of DEX as a primary sedative in the pediatric ICU. Patients and methods Thirty-seven pediatric ICU mechanically ventilated infants (1–12 months) with acute respiratory failure were randomly allocated to receive DEX infusion without a loading dose: 0.5 µg/kg/h (group I, intermediate dose, n=18) or 0.35 µg/kg/h (group II, low dose, n=19) up to 72 h. The primary outcome was University of Michigan Sedation Scale (UMSS). Secondary outcomes were supplemental sedation or analgesia, hemodynamics, withdrawal adverse effects, withdrawal assessment tool-version 1, and ICU and length of hospital stay. Results Duration of DEX infusion was (48.8±21.7 vs 37.8±21.3 h) in groups I and II (P=0.127). UMSS scores were significantly lower in group II. Supplemental sedation was needed in two patients in group II. Total ICU and hospital length of stay were 6.2±1.4 vs 3.6±1.9 days, P<0.000 and 9.9±2.2 vs 6.58±2.6 day, P=0.000, in groups I and II. Withdrawal effects in 12 h after DEX discontinuation were hypertension (1 vs1), tachycardia (1 vs 1), and agitation (1 vs 10) in groups I and II. The withdrawal assessment tool-version 1 score in 12th was (0.28±0.1 vs 0.89±0.2, P<0.02) and 24th (0.28±0.1 vs 0.79±0.2, P<0.02) in groups I and II. Conclusion Two doses produced adequate sedation with comparable opioid sparing. The low dose was associated with lower UMSS scores, more agitation following DEX discontinuation, and lower ICU and length of hospital stay.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed429    
    Printed18    
    Emailed0    
    PDF Downloaded42    
    Comments [Add]    

Recommend this journal