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Dexmedetomidine Infusion Associated with Transient Adrenal Insufficiency in a Pediatric Patient : A Case Report
Joint Authors
Cooke, David W.
Tucker, Elizabeth W.
Klaus, Sybil Ann
Kudchadkar, Sapna R.
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-05-16
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Dexmedetomidine is a highly selective α2-adrenoceptor agonist used for sedation due to its anxiolytic and analgesic properties without respiratory compromise.
Due to its structural similarity to etomidate, there has been concern that dexmedetomidine may cause adrenal insufficiency.
This concern was initially supported by animal studies, but subsequent human studies demonstrated mixed results.
We describe the case of transient adrenal insufficiency in a 1-year-old male who presented with 24% total body surface 2nd degree burns.
He required sedation with a prolonged, high-dose dexmedetomidine infusion with a peak infusion dose of 2.7 mcg/kg/hr and duration of 6.5 days.
The patient developed lethargy and hypotension four days after discontinuation of his infusion.
He had a random cortisol level which was low at 0.4 mcg/dL, and the concern for adrenal suppression was confirmed with an ACTH stimulation test with the baseline cortisol of 0.4 mcg/dL and inappropriate 60 minute post-ACTH stimulation cortisol of 7.8 mcg/dL.
While further studies will be needed to clarify the risk of adrenal suppression secondary to dexmedetomidine, this case suggests that caution should be taken when administering dexmedetomidine to pediatric patients and highlights the need for future studies to look at appropriate dosing and duration of dexmedetomidine infusions.
American Psychological Association (APA)
Tucker, Elizabeth W.& Cooke, David W.& Kudchadkar, Sapna R.& Klaus, Sybil Ann. 2013. Dexmedetomidine Infusion Associated with Transient Adrenal Insufficiency in a Pediatric Patient : A Case Report. Case Reports in Pediatrics،Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-454594
Modern Language Association (MLA)
Tucker, Elizabeth W.…[et al.]. Dexmedetomidine Infusion Associated with Transient Adrenal Insufficiency in a Pediatric Patient : A Case Report. Case Reports in Pediatrics No. 2013 (2013), pp.1-4.
https://search.emarefa.net/detail/BIM-454594
American Medical Association (AMA)
Tucker, Elizabeth W.& Cooke, David W.& Kudchadkar, Sapna R.& Klaus, Sybil Ann. Dexmedetomidine Infusion Associated with Transient Adrenal Insufficiency in a Pediatric Patient : A Case Report. Case Reports in Pediatrics. 2013. Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-454594
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-454594