Use of dexmedetomidine for sedation of children hospitalized in the intensive care unit.

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.