295 - Dexmedetomidine use in preterm infants admitted to NICU

Poster Number: 295
Publication Number: 295.344

Muppala Raju, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Shreya Jatla, Baylor Scott White McLane Children's Medical Center, Georgetown, TX, United States; Taiwo Ojewole, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Ineshia Jackson, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Venkata Raju, Texas A&M Health Science Center College of Medicine, Temple, TX, United States; Madhava R Beeram, Texas A&M Health Science Center College of Medicine, Temple, TX, United States; Niraj Vora, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Vinayak Govande, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States

Background: Most Neonatal Intensive Care Units (NICUs) use opioids such as Fentanyl and Morphine for sedation in critically ill mechanically ventilated neonates. Respiratory depression, gastrointestinal dysmotility, and duration of weaning are common adverse events associated with opioid usage. The use of dexmedetomidine in neonates is new and there is not enough data on the adverse effect profile, dosage variations, and pain scores reported by the nurses.

Objective: To examine the clinical and demographic characteristics, and to assess the side effect profile and variations in dosage of Dexmedetomidine used in neonates.

Design/Methods: Retrospective study of infants admitted to the Baylor Scott and White Memorial Hospital level IV NICU from 1/1/2017 to 12/31/2021 who required sedation and who received Dexmedetomidine as one of the drugs for sedation. Chart reviews were conducted on identified infants. Exclusion criteria included any infants who died at delivery and infants with major congenital anomalies.

Results: Overall, 59 infants were included in the study. Median Gestational age was 33.3 wks (23-41 wks). Median birth weight was 2450 gms (410 to 5755 gms). Dexmedetomidine was administered for an average duration of 4 days. The dosage of DEX ranged from 0.2 to 1.0 mcg/kg/hour. The median dosage was 0.5 mcg/kg/hour. Infants born < 32 weeks of GA received greater doses of DEX (0.6 mcg/kg/hour vs 0.4 mcg/kg/hour, p=0.06) compared to infants born > 32 weeks of GA at birth. There was no statistical difference in the incidence of bradycardia, hypotension, or inotropic use between the two groups.

Conclusion(s): The study concluded that DEX did not result in any significant adverse events. Larger studies with assessment of pain and withdrawal symptom scores would help guide NICUs in the frequent use of DEX.