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Title: The Effect of Early Sedation With Dexmedetomidine on Body Temperature in Critically Ill Patients.
Austin Authors: Grayson, Kim E;Bailey, Michael;Balachandran, Mayurathan;Banneheke, Piyusha P;Belletti, Alessandro;Bellomo, Rinaldo ;Naorungroj, Thummaporn ;Serpa Neto, Ary ;Wright, Jason D;Yanase, Fumitaka ;Young, Paul J;Shehabi, Yahya
Affiliation: Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
University of Melbourne, Parkville, VIC, Australia
Monash University, School of Clinical Sciences, Clayton, VIC, Australia
Data Analytics Research and Evaluation Centre, Austin Hospital and University of Melbourne, Melbourne, VIC, Australia
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
Intensive Care Unit, Austin Hospital, Heidelberg, VIC, Australia
Intensive Care, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
Medical Research Institute of New Zealand, Wellington, New Zealand
Intensive Care Unit, Monash Medical Centre, Clayton, VIC, Australia
University of New South Wales, Prince of Wales Clinical School of Medicine, Randwick, NSW, Australia
Issue Date: 23-Feb-2021 2021-02-23
Publication information: Critical Care Medicine 2021; online first: 23 February
Abstract: Previous case series reported an association between dexmedetomidine use and hyperthermia. Temperature data have not been systematically reported in previous randomized controlled trials evaluating dexmedetomidine. A causal link between dexmedetomidine administration and elevated temperature has not been demonstrated. Post hoc analysis. Four ICUs in Australia and New Zealand. About 703 mechanically ventilated ICU patients. Early sedation with dexmedetomidine versus usual care. The primary outcome was mean daily body temperature. Secondary outcomes included the proportions of patients with body temperatures greater than or equal to 38.3°C and greater than or equal to 39°C, respectively. Outcomes were recorded for 5 days postrandomization in the ICU. The mean daily temperature was not different between the dexmedetomidine (n = 351) and usual care (n = 352) groups (36.84°C ± SD vs 36.78°C ± SD; p = 0.16). Over the first 5 ICU days, more dexmedetomidine group (vs usual care) patients had a temperature greater than or equal to 38.3°C (43.3% vs 32.7%, p = 0.004; absolute difference 10.6 percentage points) and greater than or equal to 39.0°C (19.4% vs 12.5%, p = 0.013; absolute difference 6.9 percentage points). Results were similar after adjusting for diagnosis, admitting temperature, age, weight, study site, sepsis occurrence, and the time from dexmedetomidine initiation to first hyperthermia recorded. There was a significant dose response relationship with temperature increasing by 0.30°C ±0.08 for every additional 1 μg/kg/hr of dexmedetomidine received p < 0.0002. Our study suggests potentially important elevations in body temperature are associated with early dexmedetomidine sedation, in adults who are mechanically ventilated in the ICU.
DOI: 10.1097/CCM.0000000000004935
PubMed URL: 33729724
Type: Journal Article
Appears in Collections:Journal articles

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