ArticleThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
Prolonged Dexmedetomidine Infusion and Drug Withdrawal In Critically Ill Children.
Article in The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Protocolized Initiation of Clonidine to Prevent Dexmedetomidine Withdrawal: A Prospective Cohort Study
A Prospective Study on the Effects of Early Dexmedetomidine Administration on Sympathetic Nervous System Activity, Pathophysiological Mechanisms, and Clinical Outcomes in Sepsis
Who cites it
25 citing papers in PubMed, 42 citations in OpenAlex.
- Tiered Approach to Clonidine Dosing to Prevent Dexmedetomidine Withdrawal in Children: A Prospective Pre and Post Interventional Cohort Study.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026Article
- Tiny doses, big impact: Optimizing sedation weaning to reduce opioid use in a Level IV NICU.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Therapeutic Potential of Anesthesiology for Sleep Disorders in the Perioperative Period.Current neuropharmacology · 2026Review
- Evaluation of Institution-Specific Strategy for Converting Dexmedetomidine to Clonidine in a Pediatric Cardiac Intensive Care Unit.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Biochemical Identification and Clinical Description of Medetomidine Exposure in People Who Use Fentanyl in Philadelphia, PA.International journal of molecular sciences · 2025Article
- Dexmedetomidine: Shifting Paradigms in Neonatal Sedation and Pain Control.Children (Basel, Switzerland) · 2025Review
- Role of Dexmedetomidine and Clonidine With Hyperbaric Ropivacaine in Subarachnoid Block: A Comprehensive Review.Cureus · 2024Review
- Article
- Review
- Analgesia and sedation in critically ill pediatric patients: an update from the recent guidelines and point of view.European journal of pediatrics · 2023Review
- Clonidine use during dexmedetomidine weaning: A systematic review.World journal of critical care medicine · 2023Article
- Evaluation of an Enteral Clonidine Taper following Prolonged Dexmedetomidine Exposure in Critically Ill Children.Journal of pediatric intensive care · 2022Article
- Recommendations for analgesia and sedation in critically ill children admitted to intensive care unit.Journal of anesthesia, analgesia and critical care · 2022Review
- Biased, Bitopic, Opioid-Adrenergic Tethered Compounds May Improve Specificity, Lower Dosage and Enhance Agonist or Antagonist Function with Reduced Risk of Tolerance and Addiction.Pharmaceuticals (Basel, Switzerland) · 2022Review
- Changes in Sedation Practices in Association with Delirium Screening in Infants After Cardiopulmonary Bypass.Pediatric cardiology · 2021Article
- Towards Evidence-Based Weaning: a Mechanism-Based Pharmacometric Model to Characterize Iatrogenic Withdrawal Syndrome in Critically Ill Children.The AAPS journal · 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
- 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
- Dexmedetomidine in Enhanced Recovery After Surgery (ERAS) Protocols for Postoperative Pain.Current pain and headache reports · 2020Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo characterise the incidence, symptoms and risk factors for withdrawal associated with prolonged dexmedetomidine infusion in paediatric critically ill patients.
methodsRetrospective chart review in the paediatric intensive care unit and the cardiac critical care unit of a single tertiary children's hospital. Patients up to 18 years old, who received dexmedetomidine for longer than 48 hours were included.
resultsA total of 52 patients accounted for 68 unique dexmedetomidine treatment courses of more than 48 hours. We identified 24 separate episodes of withdrawal in the 68 dexmedetomidine courses (incidence 35%). Of these episodes 38% occurred in patients who were weaned from dexmedetomidine alone while the remaining occurred in patients who had concurrent weans of opioids and/or benzodiazepines. Most common symptoms were agitation, fever, vomiting/retching, loose stools and decreased sleep. The symptoms occurred during the latter part of the wean or after discontinuation of dexmedetomidine. A cumulative dose of dexmedetomidine of 107 mcg/kg prior to initiation of wean was more likely associated with withdrawal (this equates to a dexmedetomidine infusion running at 1 mcg/kg/hr over 4 days). Duration of opioid use was an additional risk factor for withdrawal. The use of clonidine, as a transition from dexmedetomidine, did not protect against withdrawal (p = 1).
conclusionsA withdrawal syndrome may occur after prolonged infusion of dexmedetomidine. As all our patients were also exposed to opioids this may be affected by the duration of opioid use. We identified a cumulative dose of 107 micrograms/kg of dexmedetomidine beyond which withdrawal symptoms were more likely (which equates to 4 days of use at a dose of 1 mcg/kg/hr). A protocol for weaning should be considered in this circumstance.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.