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01-05-2010 | Pediatric Original

Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease

Authors: Constantinos Chrysostomou, Rukmini Komarlu, Steven Lichtenstein, Dana Shiderly, Gaurav Arora, Richard Orr, Peter D. Wearden, Victor O. Morell, Ricardo Munoz, Edmund H. Jooste

Published in: Intensive Care Medicine | Issue 5/2010

Abstract

Objective

Assessment of electrocardiographic (ECG) effects of dexmedetomidine.

Design

Prospective observational study including children 0–17 years of age with congenital heart disease (CHD) and children following cardiothoracic surgery. Patients who did not receive dexmedetomidine were used as a control group. All patients had two ECGs: one baseline, pre-dexmedetomidine (T1) and one during dexmedetomidine infusion (T2).

Measurements and results

Fifty-one patients, median age of 0.5 years (IQR = 3.4), and 25 patients, age 0.25 (IQR = 2.9), were included in the dexmedetomidine and control groups, respectively. Forty received a dexmedetomidine-loading dose of 1 µg/kg (IQR = 0.5). At T2, the dexmedetomidine infusion was 1 µg/kg/h (IQR = 0.5). In the dexmedetomidine group, heart rate (HR) decreased from 140 ± 22 to 115 ± 23 (P < 0.001); PR, PRc and PR index changed from 115 ± 28 to 122 ± 29 ms (P = 0.01), 174 ± 38 to 167 ± 35 ms (P = 0.07) and 15,882 ± 3,565 to 13,792 ± 3,311 (P < 0.001), respectively. QRS decreased from 84 ± 21 to 80 ± 21 ms (P = 0.02), and QTc had no change (433 ± 47 to 435 ± 36 ms). When compared to the control group, none of the ECG intervals had any difference other than a trend towards lower HR (P = 0.08). Neonates and infants had a bigger drop in the HR compared to older children (P < 0.001), while other parameters were similar. At T2 none of the dexmedetomidine group patients had atrioventricular block or other arrhythmia. Four patients in the control group had accelerated junctional rhythm.

Conclusions

Use of dexmedetomidine in patients with CHD and patients following cardiothoracic surgery is not associated with any significant ECG interval abnormalities other than a trend towards lower HR.

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Title: Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease
Authors: Constantinos Chrysostomou
Rukmini Komarlu
Steven Lichtenstein
Dana Shiderly
Gaurav Arora
Richard Orr
Peter D. Wearden
Victor O. Morell
Ricardo Munoz
Edmund H. Jooste
Publication date: 01-05-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 5/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-010-1782-z

At a glance: The STEP trials

Springer Medicine

Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease

Abstract

Objective

Design

Measurements and results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design

Measurements and results

Conclusions

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