The Use of Dexmedetomidine for Sedation in the Pediatric Intensive Care Unit

Abstract

Dexmedetomidine is a centrally acting alpha2-adrenergic agonist that provides sedation with minimal respiratory depression. The medication's targeted activation of alpha2-receptors mediates its sedative, anxiolytic, and analgesic effects. Although dexmedetomidine is approved only for sedation in adults, it is currently being used off-label as an adjunctive agent in pediatric patients for sedation and analgesia in the critical care unit and for sedation during non-invasive procedures in radiology. Despite the lack of large randomized controlled trials, available literature and case studies suggest dexmedetomidine may be an effective alternative or adjunctive sedative in pediatric patients. The purpose of this study is to evaluate the use of dexmedetomidine in the Pediatric Intensive Care Unit (PICU) at Blank Children's Hospital (BCH) by assessing safety, efficacy, dosing, and duration of dexmedetomidine courses in mechanically ventilated infants and children. The study will also assess length of stay, time on the ventilator, extubation while receiving dexmedetomidine infusion, and necessity for use of other sedative and narcotic infusions. These objectives will be assessed through retrospective chart review of all patients who received dexmedetomidine while in the PICU between March 2007 and January 2009. Analysis will include descriptive statistics on the data obtained. The results will add to the small volume of existing evidence regarding dexmedetomidine's use in the pediatric population.