Journal of hospital medicine · 2008
Use of dexmedetomidine for sedation of children hospitalized in the intensive care unit.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Carroll Christopher L, Krieger Diane, Campbell Margaret, Fisher Daniel G, Comeau Leonard L, Zucker Aaron R
Аннотация
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 university-affiliated 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 0.1-17.2 years). The most common indications for ICU admission were respiratory distress/failure (53%), status-postcorrective cardiac surgery (19%), and other postoperative patients (18%). In 53% of cases dexmedetomidine was used to supplement ongoing sedation judged inadequate 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 microg/kg per hour (range 0.2-2.5 microg/kg per hour), with a median duration of therapy of 23 hours (range 3-451 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.
OBJECTIVE: To report our experience with dexmedetomidine for the sedation of hospitalized children.
DESIGN: Retrospective case series.
SETTING: Pediatric ICU of a university-affiliated 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 0.1-17.2 years). The most common indications for ICU admission were respiratory distress/failure (53%), status-postcorrective cardiac surgery (19%), and other postoperative patients (18%). In 53% of cases dexmedetomidine was used to supplement ongoing sedation judged inadequate 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 microg/kg per hour (range 0.2-2.5 microg/kg per hour), with a median duration of therapy of 23 hours (range 3-451 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.