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Usability of dexmedetomidine for deep sedation in infants and small children with respiratory morbidities

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Najafi, Nadia Veyckemans, Francis [UCL] Van de Velde, Anne Poelaert , Jan

Background: Children with respiratory morbidities are at increased risk of developing adverse respiratory events while undergoing deep sedation. Dexmedetomidine possesses sedative properties with minimal respiratory depression. This report aimed to determine the usability of dexmedetomidine in children with significant respiratory morbidities who require deep sedation. Methods: Medical records of children with ASA classification III who had at least three characteristics of respiratory morbidities and who received dexmedetomidine sedation for magnetic resonance imaging (MRI) between January 2014 and May 2015 were retrospectively reviewed. Dexmedetomidine was administered as a bolus of 1 μg/kg over 10 min followed by 1 μg/kg/h infusion. If necessary, an additional bolus dose was given and the infusion rate was increased to 2 μg/kg/h. Respiratory morbidities, haemodynamic parameters, total dexmedetomidine dose, adverse cardiorespiratory events and sedation characteristics were analysed. Results: Nineteen out of 642 children who underwent MRI were eligible for evaluation. Seventeen children (89%) had at least four characteristics of respiratory morbidities. The median [IQR] age was 9 months [3.5–14]. All patients completed MRI scans while breathing spontaneously via the native airway. No episodes of adverse respiratory events or haemodynamic instability were observed. Children who were administered a lower dexmedetomidine dose and had a shorter sedation time were more likely to be younger than 1 year of age. Conclusion: These data demonstrate that dexmedetomidine deep sedation was well-tolerated in children with significant respiratory morbidities. Moreover, children younger than 1 year of age were administered lower dexmedetomidine dose than children older than 1 year of age for the same sedation level. Trial registration: ClinicalTrials.gov identifier NCT02555605

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2016
Language Anglais
Journal information "Acta Anaesthesiologica Scandinavica : an international journal of anaesthesiology and intensive care, pain and emergency medicine" - Vol. 60, no.7, p. 865-873 (2016)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing, Inc. ((United Kingdom) Oxford)
issn 0001-5172
e-issn 1399-6576
Publication status Publié
Affiliations UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire
UCL - (SLuc) Service d'anesthésiologie
MESH Subject Child ; Deep Sedation ; Dexmedetomidine ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Infant ; Retrospective Studies
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Bibliographic reference Najafi, Nadia ; Veyckemans, Francis ; Van de Velde, Anne ; Poelaert , Jan. Usability of dexmedetomidine for deep sedation in infants and small children with respiratory morbidities. In: Acta Anaesthesiologica Scandinavica : an international journal of anaesthesiology and intensive care, pain and emergency medicine, Vol. 60, no.7, p. 865-873 (2016)
Permanent URL http://hdl.handle.net/2078.1/184944