ArticleSAGE open medicine2015
Evaluating the transition from dexmedetomidine to clonidine for agitation management in the intensive care unit.
Article in SAGE open medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Iatrogenic withdrawal syndrome in adult intensive care unit: a scoping review.Frontiers in medicine · 2025Pooled it
- A systematic review of interventions to facilitate extubation in patients difficult-to-wean due to delirium, agitation, or anxiety and a meta-analysis of the effect of dexmedetomidine.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2019Pooled it
- Clonidine for Management of Agitation in Delirious Patients.Current psychiatry reports · 2025Review
- Role of Dexmedetomidine and Clonidine With Hyperbaric Ropivacaine in Subarachnoid Block: A Comprehensive Review.Cureus · 2024Review
- Clonidine use during dexmedetomidine weaning: A systematic review.World journal of critical care medicine · 2023Article
- Effect of Enteral Guanfacine on Dexmedetomidine Use in the ICU.Critical care explorations · 2022Article
- Refractory Psychomotor Agitation Responding to Dexmedetomidine Infusion: A Rare Presentation of Bickerstaff Brainstem Encephalitis (BBE).Neurocritical care · 2021Article
- Prevention of Withdrawal in Pediatric Patients Receiving Long-term Dexmedetomidine Infusions.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
- Challenges in Sedation Management in Critically Ill Patients with COVID-19: a Brief Review.Current anesthesiology reports · 2021Review
- Clonidine for the Treatment of Agitation After Dexmedetomidine Discontinuation in Pediatric Patients: A Retrospective Cohort Study.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
- Effects of a Clonidine Taper on Dexmedetomidine Use and Withdrawal in Adult Critically Ill Patients-A Pilot Study.Critical care explorations · 2020Article
- Incidence of Dexmedetomidine Withdrawal in Adult Critically Ill Patients: A Pilot Study.Critical care explorations · 2019Article
- Chronic Pain and Chronic Opioid Use After Intensive Care Discharge - Is It Time to Change Practice?Frontiers in pharmacology · 2019Review
- Effectivness of Clonidine in Treating Dexmedetomidine Withdrawal in a Patient with Co-Existing Psychiatric Illness: A Case Report.The American journal of case reports · 2018Article
- Altered Mental Status in Patients Hospitalized with COVID-19: Perspectives from Neurologic and Psychiatric Consultants.Harvard review of psychiatryArticle
- Consensus for the management of analgesia, sedation and delirium in adults with COVID-19-associated acute respiratory distress syndrome.Revista Brasileira de terapia intensivaReview
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLimited literature exists examining the use of enteral clonidine to transition patients from dexmedetomidine for management of agitation. The aim of this study was to evaluate dexmedetomidine discontinuation within 8 h of enteral clonidine administration in addition to the rates of dexmedetomidine re-initiation in patients who failed clonidine transition.
methodsA single-center, retrospective analysis evaluated critically ill adult patients from 1 February 2013 to 28 February 2014, who used dexmedetomidine and clonidine for sedation management. Patients were excluded if they received enteral clonidine for reasons other than sedation management. Secondary aims of the study observed time to dexmedetomidine discontinuation, agitation (Richmond Agitation Sedation Scale) and delirium ratings (Confusion Assessment Method for the intensive care unit), clonidine dose, and enteral clonidine discontinuation.
resultsIn all, 26 patients were evaluated. Demographics included a mean age of 54.4 (±16.7) years, Acute Physiology and Chronic Health Evaluation II score of 18 (interquartile range = 14-22), and 80.7% of admissions to the cardiac surgery intensive care unit. Dexmedetomidine discontinuation occurred in 17 (65.4%) patients within 8 h of receiving clonidine. The total median clonidine exposure per intensive care unit day was 0.35 mg/ICU day (interquartile range = 0.2-0.5) in patients who discontinued dexmedetomidine within 8 h and 0.5 mg/ICU day (interquartile range = 0.4-1.0) (p = 0.036) in patients who did not. We observed similar Richmond Agitation Sedation Scale and Confusion Assessment Method for the intensive care unit scores and rates of hypotension. Unintentional use of clonidine beyond ICU and hospital stay was observed in 54% and 23% of patients, respectively.
conclusionEnteral clonidine may be an effective and safe alternative to transition patients off of dexmedetomidine for ongoing sedation management. Clinicians should critically evaluate the need for clonidine at ICU and hospital discharge. More studies comparing the use of clonidine to transition from dexmedetomidine infusions are needed.
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