ArticleCritical care explorations2019
Incidence of Dexmedetomidine Withdrawal in Adult Critically Ill Patients: A Pilot Study.
Article in Critical care explorations, 2019. 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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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Iatrogenic withdrawal syndrome in adult intensive care unit: a scoping review.Frontiers in medicine · 2025Pooled it
- Delirium in neurosurgery: a systematic review and meta-analysis.Neurosurgical review · 2022Pooled it
- Paroxysmal supraventricular tachycardia associated with dexmedetomidine withdrawal in an adult liver transplant recipient: A case report.World journal of critical care medicine · 2026Article
- Dexmedetomidine in Palestinian intensive care units: The first multicenter cross-sector survey of sedation practices, protocol gaps, and withdrawal challenges.SAGE open medicine · 2026Article
- Delirium Management in Critical Care: Are We Moving Forward or Still Treading Water?Medical sciences (Basel, Switzerland) · 2025Review
- Case Series: Repeated Brief Dexmedetomidine Infusion to Prevent Withdrawal and Worsening in Alcohol Withdrawal Delirium.Indian journal of psychological medicine · 2025Article
- Biochemical Identification and Clinical Description of Medetomidine Exposure in People Who Use Fentanyl in Philadelphia, PA.International journal of molecular sciences · 2025Article
- Notes from the Field: Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients - Philadelphia, Pennsylvania, September 2024-January 2025.MMWR. Morbidity and mortality weekly report · 2025Article
- Article
- 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
- How to Manage Withdrawal of Sedation and Analgesia in Mechanically Ventilated COVID-19 Patients?Journal of clinical medicine · 2021Review
- A Clinician's Guide to Dosing Analgesics, Anticonvulsants, and Psychotropic Medications in Continuous Renal Replacement Therapy.Kidney international reports · 2021Review
- Dexmedetomidine in COVID-19: probing promises with prudence!The American journal of emergency medicine · 2021Article
- Effects of a Clonidine Taper on Dexmedetomidine Use and Withdrawal in Adult Critically Ill Patients-A Pilot Study.Critical care explorations · 2020Article
- Severe Fentanyl Withdrawal Associated With Medetomidine Adulteration: A Multicenter Study From Philadelphia, PA.Journal of addiction medicineArticle
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To determine the incidence of dexmedetomidine withdrawal in adult critically ill patients.
designThis was a prospective, observational study of patients from November 2017 to December 2018.
settingMedical-surgical, cardiothoracic, and neurosurgical ICUs in a tertiary care hospital. PATIENTS: Adult critically ill patients on dexmedetomidine infusions for at least 3 days.
interventionsIndicators of withdrawal were assessed at baseline and at least daily during the dexmedetomidine wean period. Delirium was assessed using the Confusion Assessment Method for the ICU. Sedation was assessed using the Richmond Agitation-Sedation Scale. The Withdrawal Assessment Tool-1 was performed and vital signs were recorded during each assessment. Patients were considered positive for dexmedetomidine withdrawal if they had two or more of the following symptoms: positive Confusion Assessment Method for the ICU, Richmond Agitation-Sedation Scale greater than +1, positive Withdrawal Assessment Tool-1 assessment, tachycardia (heart rate > 90 beats/min), and hypertension (systolic blood pressure > 140 mm Hg or mean arterial pressure > 90). MEASUREMENTS AND MAIN
resultsForty-two patients were included in the study, with 64% of patients experiencing signs of dexmedetomidine withdrawal. The median time on dexmedetomidine for all patients was 9.6 days (5.8-12.7 d), and the median dose of dexmedetomidine received was 0.8 µg/kg/hr (0.5-1 µg/kg/hr). Of the patients who were positive for withdrawal, the most prevalent withdrawal symptoms observed included delirium, hypertension, and agitation (93%, 48%, and 33%, respectively). We found no correlation between chronic opioid tolerance and incidence of withdrawal symptoms. Peak dexmedetomidine doses greater than 0.8 µg/kg/hr and cumulative daily doses of dexmedetomidine greater than 12.9 µg/kg/d were associated with a higher incidence of withdrawal.
conclusionsThe majority of patients in our study demonstrated signs that may be indicative of dexmedetomidine withdrawal. Peak and cumulative daily dexmedetomidine dose, rather than duration of therapy, may be associated with a higher incidence of withdrawal signs. Regular screening of patients on prolonged dexmedetomidine infusions is recommended to ensure safe and effective use in critically ill patients.
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