Abstract
Objective
This study aimed to evaluate cardiorespiratory status in preterm infants receiving dexmedetomidine using high-resolution physiologic data.
Study Design
We analyzed preterm infants with continuous heart rate (HR) and oxygen saturation (SpO2) data for 24 hours preceding and 48 hours following dexmedetomidine initiation. Invasive arterial blood pressure (ABP), when available, was analyzed.
Results
In 100 infants with a mean gestational age of 28 weeks and high baseline illness severity, mean HR decreased from 152 to 141 beats per minute while mean SpO2 increased from 91 to 93% in the 48 hours after dexmedetomidine initiation (p < 0.01). In 57 infants with continuous ABP monitoring, mean ABP increased from 40 to 42 mm Hg (p = 0.01). Vasoactive-inotropic support increased before and after initiation.
Conclusion
We observed cardiorespiratory changes in critically ill preterm infants following dexmedetomidine initiation; mean HR decreased and mean SpO2 increased in the 48 hours after initiation. In a subset, mean ABP increased along with vasoactive-inotropic support.
Key Points
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Limited evidence exists on the acute cardiorespiratory effects of dexmedetomidine in preterm infants.
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Evaluation of continuous HR, blood pressure, and oxygenation from two centers provides useful data.
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Dexmedetomidine consistently decreased the HR of preterm infants.
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Dexmedetomidine initiation during critical illness complicated the interpretation of physiologic effects.
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Oxygenation stabilized after initiation during invasive mechanical ventilation.
Keywords
preterm infants - dexmedetomidine - heart rate - oxygenation - arterial blood pressure
