Buy Article Permissions and Reprints 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

Limited evidence exists on the acute cardiorespiratory effects of dexmedetomidine in preterm infants.

Evaluation of continuous HR, blood pressure, and oxygenation from two centers provides useful data.

Dexmedetomidine consistently decreased the HR of preterm infants.

Dexmedetomidine initiation during critical illness complicated the interpretation of physiologic effects.

Oxygenation stabilized after initiation during invasive mechanical ventilation.

Keywords preterm infants - dexmedetomidine - heart rate - oxygenation - arterial blood pressure Ethical Approval

This project was submitted and approved by the local ethics review board at the University of Virginia and Washington University at St. Louis and was approved under a waiver of consent for retrospective studies. This study was performed in accordance with the declaration of Helsinki.

Data Availability

The dataset from this study would be made available upon reasonable request from qualified investigators to the corresponding author.

Authors' Contributions

B.A.S., P.H., C.M., and Z.A.V. substantially contributed to the conception, design, analysis, and interpretation of data. H.K. and B.Z. substantially contributed to the acquisition of data. B.A.S. and C.M. drafted the article with Z.A.V. revising it critically for important intellectual content. All authors approved the final version to be published.

Publication History

Received: 12 July 2024

Accepted: 17 October 2024

Accepted Manuscript online:
18 October 2024

Article published online:
27 November 2024

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