Journal of perinatology : official journal of the California Perinatal Association · 2025
Dexmedetomidine as the primary sedative in the NICU.
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Caballero Alexandra, Bashqoy Ferras, Spilios Maria, Saad Anasemon, Tracy Joanna, Verma Sourabh, Wachtel Elena V
Аннотация
OBJECTIVES: To evaluate the safety and efficacy of dexmedetomidine as the primary sedative in neonates.
STUDY DESIGN: Single center, retrospective study of mechanically ventilated neonates sedated with dexmedetomidine (study group) or opioids/benzodiazepines (control group). Primary outcome was requirement of opioids/benzodiazepines. Secondary outcomes included duration of mechanical ventilation, time to full feeds, bradycardia/hypotension, and unplanned extubation. A subgroup analysis was conducted in premature neonates.
RESULTS: There were 148 patients (study group n = 91, control group n = 57) included. Patients who received dexmedetomidine had less cumulative exposure to opioids/benzodiazepines. The median opioid/benzodiazepine requirement was 0 mg/kg/day in the study group compared to the control group with 0.36-0.96 mg/kg/day midazolam equivalents and 1.75-4.1 mg/kg/day morphine equivalents. Unplanned extubations were not different between groups indicating similar efficacy. The study group reached full feeds faster than the control group.
CONCLUSION: Dexmedetomidine as the primary sedative in neonates is safe and efficacious at minimizing opioids and benzodiazepines in both term and premature neonates.
CLINICAL TRIAL REGISTRATION: N/A.
STUDY DESIGN: Single center, retrospective study of mechanically ventilated neonates sedated with dexmedetomidine (study group) or opioids/benzodiazepines (control group). Primary outcome was requirement of opioids/benzodiazepines. Secondary outcomes included duration of mechanical ventilation, time to full feeds, bradycardia/hypotension, and unplanned extubation. A subgroup analysis was conducted in premature neonates.
RESULTS: There were 148 patients (study group n = 91, control group n = 57) included. Patients who received dexmedetomidine had less cumulative exposure to opioids/benzodiazepines. The median opioid/benzodiazepine requirement was 0 mg/kg/day in the study group compared to the control group with 0.36-0.96 mg/kg/day midazolam equivalents and 1.75-4.1 mg/kg/day morphine equivalents. Unplanned extubations were not different between groups indicating similar efficacy. The study group reached full feeds faster than the control group.
CONCLUSION: Dexmedetomidine as the primary sedative in neonates is safe and efficacious at minimizing opioids and benzodiazepines in both term and premature neonates.
CLINICAL TRIAL REGISTRATION: N/A.