Language
English
Publication Date
8-1-2024
Journal
Journal of Pharmacy Practice
DOI
10.1177/08971900231193558
PMID
37540811
PMCID
PMC11287952
PubMedCentral® Posted Date
8-4-2023
PubMedCentral® Full Text Version
Post-print
Abstract
Background: Dexmedetomidine, an alpha 2 agonist, has emerged as a desirable sedative agent in the pediatric intensive care unit due to its minimal effect on respiratory status and reduction in delirium. Bradycardia and hypotension are common side effects, however there are emerging reports of more serious cardiovascular events, including sinus arrest and asystole. These case reports have been attributed to high vagal tone or underlying cardiac conduction dysfunction.
Objectives: To describe the development of sinus arrest during sedation with dexmedetomidine in a patient without clinical features of high vagal tone, underlying cardiac conduction dysfunction, or intervening episodes of bradycardia.
Case Presentation: An 11 month-old patient requiring sedation during mechanical ventilation for acute respiratory failure secondary to Adenovirus. To facilitate sedation, a dexmedetomidine infusion was initiated at .5 mcg/kg/hr and increased to maximum 1 mcg/kg/hr. Within 8 hours of initiating therapy, the patient had three episodes of sinus arrest. There was no intervening bradycardia between episodes and no further episodes occurred following discontinuation of dexmedetomidine. The patient did not have any clinical features associated with high vagal tone or underlying cardiac conduction dysfunction.
Conclusions: As result of these findings, understanding risk factors for bradycardia, or more serious hemodynamic instability with dexmedetomidine infusions, is important to help identify high risk patients and weigh the associated risks and benefits of its administration.
Keywords
Humans, Infant, Dexmedetomidine, Hypnotics and Sedatives, Infusions, Intravenous, Sinus Arrest, Cardiac
Published Open-Access
yes
Recommended Citation
Dennee, Alexandra; Fogarty, Thomas P; Howard, Taylor S; et al., "Sinus Arrest Related to Dexmedetomidine Infusion in an Infant; a Case Report and Review of Current Literature" (2024). Faculty and Staff Publications. 5759.
https://digitalcommons.library.tmc.edu/baylor_docs/5759