55 Adverse Events Following the Combination of Dexmedetomidine with Therapeutic Hypothermia in a Piglet Asphyxia Model. (October 2012)

• Record Type: Journal Article
• Authors: Ezzati, M; Broad, K; Kawano, G; Fiorens, I; Kawano, K; Rostami, J; Cady, E; Gressens, P; Sanders, R; Golay, X; Robertson, NJ
• Is Part Of: Archives of disease in childhood. Volume 97(2012)Supplement 2
• Page Start: A15
• Page End: A16
• Publication Date: 2012-10
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2012-302724.0055
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Dexmedetomidine (DXM) is a potent, selective a2 adrenoceptor agonist which exerts sedative, neuroprotective, analgesic and anti-inflammatory properties that may be beneficial for neonatal asphyxia. The safety of DXM combined with therapeutic hypothermia is unknown. Aim: To assess safety of low (0.6–1.5mcg/kg/h) and high dose (10mcg/kg/h) DXM with hypothermia as part of a larger study investigating neuroprotection with DXM-augmented cooling. Methods: Following a quantified hypoxic-ischaemic insult, 16 male piglets were randomized to either hypothermia alone (33.5oC from 4–22h, n=7) or DXM plus hypothermia (n=9). Mean arterial blood pressure (MABP) was measured continuously; when MABP was < 40mmHg, a saline bolus was given followed by inotropes. At 48 h the experiment was terminated. Results: There was no difference in baseline variables. Compared to hypothermia only, the DXM hypothermia group required more saline, adrenaline and cardiac arrests (all p<0.05). These adverse events occurred at both high and low dose DXM. Conclusion: Adverse cardiovascular events with low and high dose DXM combined with cooling occurred mainly after 16 h and could be due to perturbed central autonomic function, vasoconstriction via peripheral alpha adrenoceptor stimulation or effects on the imidazoline receptor.