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Dexmedetomidine affects cerebral activity in preterm infants
  1. Cristina Cortes-Ledesma,
  2. Luis Arruza,
  3. Angela Sainz-Villamayor,
  4. José Martínez-Orgado
  1. Division of Neonatology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
  1. Correspondence to Dr Cristina Cortes-Ledesma, Neonatology, Hospital Clínico San Carlos, Madrid, Spain; crispucortes{at}gmail.com

Abstract

The use of dexmedetomidine (DEX) has been extended in preterm newborns, but the effects on cerebral activity and their relationship with haemodynamic changes has not been studied.

We retrospectively studied the effects of DEX administered to 10 preterm newborns, assessing amplitude-integrated EEG (aEEG) parameters, brain regional SO2 (brSO2), heart rate, non-invasive mean blood pressure (MBP), transcutaneous oxygen saturation (SpO2), venous pCO2 and haemoglobin (Hb) values, in two 6-hour periods: one starting 6 hours before the beginning of DEX perfusion and the other 6 hours afterwards.

DEX infusion led to brSO2 decrease not associated to heart rate, MBP, SpO2, Hb or pCO2 variation, which suggests that brSO2 decrease could be related to local vasoconstriction. DEX infusion led to prolongation of interburst interval and reduction of cycling. Such effects, not been described so far, should be considered in the assessment of aEEG traces after DEX administration to avoid misinterpretations regarding patient’s prognosis. More studies are needed to assess the safety of DEX use in the newborn.

  • Neonatology
  • Neurology
  • Intensive Care Units, Paediatric
  • Intensive Care Units, Neonatal
  • Pain

https://doi.org/10.1136/archdischild-2021-323411

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    Footnotes

    • Contributors CL conceptualised and designed the study, collected data, carried out the initial analyses and drafted the initial manuscript. SV and LA designed the data collection instruments, collected data and revised the manuscript. MO conceptualised and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.