Use of Dexmedetomidine for Sedation of Ventilated Premature Iinfants

[PamelaP]

Does anyone have any experience with using Dexmedetomidine for sedation in the ventilated premature infant? This drug is being used more frequently in the adult population. Dexmedetomidine is a short acting alpha 2-agonist with anxiolytic, anesthetic, hypnotic and analgesic properties. The advantage to the medication is that it does not affect the respiratory drive and therefore does not interfere with weaning from mechanical ventilation. Because of this characteristic, infusions of dexmedetomidine can be continued after extubation without the risk of respiratory failure, a complication that can occur with propofol, lorazepam and midazolam.

[JACK]

Personally never used it so far. But sounds interesting.

Pharmacokinetics of intravenous dexmedetomidine in children under 11 yr of age.
Br J Anaesth. 2008 May;100(5):697-700. Epub 2008 Mar 31.
LINK TO DOWNLOAD (http://bja.oxfordjournals.org/cgi/reprint/100/5/697)

Successful use of dexmedetomidine for sedation in a 24-week gestational age neonate.
Ann Pharmacother. 2009 Oct;43(10):1707-13. Epub 2009 Sep 15.
LINK TO ABSTRACT (http://www.ncbi.nlm.nih.gov/pubmed/19755621?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed _ResultsPanel.Pubmed_RVDocSum&ordinalpos=1)

Clinical uses of dexmedetomidine in pediatric patients.
Paediatr Drugs. 2008;10(1):49-69.
LINK TO ABSTRACT (http://www.ncbi.nlm.nih.gov/pubmed/18162008?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed)
LINK TO DOWNLOAD (http://pdfs.journals.adisonline.com/pediatrics/2008/10010/Clinical_Uses_of_Dexmedetomidine_in_Pediatric.6.pd f?token=method|ExpireAbsolute;source|Journals;ttl| 1267291384360;payload|mY8D3u1TCCsNvP5E421JYPPlNl9Z UXrQDsjmMHeXqBgfxP56d5BAis+WhfSrPR1S6lcHrAT5WTvTkr I7Jc1zUq2UlEn8N1x7qr2heZXbSZE2/LnQkUnbAwLtuHlqxiruZhFwwtFf4aeU4rMgwns+8TDbNbAkOUl ffcIt0OqswFvWf97qU1+XR+GRM7R1S2drJjlMZyk5umnCyX0Zs O+WQO3OqrC6kWZHGFmwsUyPoy3TkarWdvvy6Y+Y2j71uz08ZT4 8Kq4FnoD9k2sZ/f2+VtLuq7uoIKDiRliJeppVX+rw4UyT+wiUZhSlAJO7dAyjR9v myVAWVtaC6WwAPrLYreszSV1KWThE7hh6oMJQ6lmjEbXKC+gaa l/PsKlfuCcwBrUqJIORKZEJNXxZBdgr3PQsdpBR5D41VaEH2MOCV FQOReXo4fsg/YHzlI735ThKGKWml7j5Rn+50uie6sSdJqjf0QLWOa0q+IPzv3l P9DbtjtVBzj37I05+xyFEQYy8hkPvrHfu33uPvCYtoLj6J9uZa wa0r/hG4jNiOlz9FC7GJdeYruj0bK5VQBSvsgdY/dBIMeG3lNTXUCUcvJSluK0aGIw6Dz6nHkcE/3S4anFLYlT+riIYTCGiEX23hvUO;hash|e+zgcAHFvMSU3PLWA Wlqmw==)

On a related note:
Here is an informative article:

Sedation of hypercyanotic spells in a neonate with tetralogy of Fallot using dexmedetomidine
J Pediatr (Rio J). 2008;84(4):377-380
LINK TO DOWNLOAD (http://www.jped.com.br/conteudo/08-84-04-377/ing.pdf)