Dexmedetomidine for Sedation during Withdrawal of Support

Palliative Care
Chris O'HaraGary D Ceneviva

Abstract

Agents used to control end-of-life suffering are associated with troublesome side effects. The use of dexmedetomidine for sedation during withdrawal of support in pediatrics is not yet described. An adolescent female with progressive and irreversible pulmonary deterioration was admitted. Despite weeks of therapy, she did not tolerate weaning of supplemental oxygen or continuous bilevel positive airway pressure. Given her condition and the perception that she was suffering, the family requested withdrawal of support. Despite opioids and benzodiazepines, she appeared to be uncomfortable after support was withdrawn. Ketamine was initiated. Relief from ketamine was brief, and its use was associated with a "wide-eyed" look that was distressing to the family. Ketamine was discontinued and a dexmedetomidine infusion was initiated. The patient's level of comfort improved greatly. The child died peacefully 24 hours after initiating dexmedetomidine from her underlying disease rather than the effects of the sedative.

References

Jun 1, 1997·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·L A TrisselJ F Martinez
Mar 7, 2000·Anesthesia and Analgesia·J E HallT J Ebert
Apr 20, 2001·Journal of Pain and Symptom Management·T MoritaS Chihara
Oct 30, 2001·Anesthesia and Analgesia·A M De WolfF Rahimi-Danesh
Aug 17, 2002·Journal of Pain and Symptom Management·Luiz Guilherme L SoaresGeralda Peixoto
Apr 30, 2004·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Christine A Zawistowski, Michael A DeVita
Sep 17, 2004·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Tatsuya MoritaUNKNOWN Japan Pain, Rehabilitation, Palliative Medicine, and Psycho-Oncology (J-PRPP) Study Group
Nov 27, 2004·Anesthesiology·Rogerio L R Videira, Roberto Manara V Ferreira
Jun 18, 2005·Paediatric Anaesthesia·Gregory B HammerPeter J Koltai
Jul 30, 2005·Anesthesiology·Christopher D KentJoseph Lowy
Feb 24, 2006·Paediatric Anaesthesia·Lucinda L EverettJeffrey G Ojemann
Mar 29, 2006·Journal of Burn Care & Research : Official Publication of the American Burn Association·James WalkerJohn McCall
Feb 3, 2007·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Joseph D Tobias
Aug 30, 2007·Pacing and Clinical Electrophysiology : PACE·Arti N ShahFrederick A Ehlert
Nov 17, 2007·Acta Anaesthesiologica Scandinavica·E HuupponenS Jääskeläinen
Dec 29, 2007·Paediatric Drugs·Hanna Phan, Milap C Nahata
Jan 1, 2008·Anesthesia and Analgesia·Gregory B HammerAnne M Dubin
May 20, 2008·Expert Opinion on Drug Metabolism & Toxicology·Constantinos Chrysostomou, Carol G Schmitt
Jan 22, 2009·Cardiology in the Young·Sharon BejianBrigham C Willis
Oct 28, 2009·Palliative Medicine·Nathan I ChernyUNKNOWN Board of the European Association for Palliative Care
Apr 24, 2010·Paediatric Anaesthesia·Mohamed MahmoudLane F Donnelly
Aug 30, 2012·Journal of Burn Care & Research : Official Publication of the American Burn Association·Erik S ShankJ A Jeevendra Martyn
Nov 14, 2012·Journal of Burn Care & Research : Official Publication of the American Burn Association·Alice FaginSoman Sen
Mar 21, 2013·Congenital Heart Disease·Kristin M Burns, E Anne Greene

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Citations

Jun 27, 2019·Journal of Pain & Palliative Care Pharmacotherapy·Russell Jeffrey SeymorePatrick J Coyne

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Methods Mentioned

BETA
sedation

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