Dexmedetomidine-associated hyperthermia: A retrospective cohort study of intensive care unit admissions between 2009 and 2016

Dexmedetomidine-associated hyperthermia: A retrospective cohort study of intensive care unit admissions between 2009 and 2016

Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature >=39.5 degreesC, incl...

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Bibliographic Details
Published in:Anaesthesia and intensive care Vol. 45; no. 6; pp. 727 - 736
Main Authors: Grayson, K. E. D., Tobin, A. E., Lim, D. T. K., Reid, D. E., Ghani, M.
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-11-2017
Sage Publications Ltd
Subjects:
Adult
Aged
Anesthesia
Anesthesiology
Body temperature
Chemotherapy
Cohort analysis
Complications
Critical care
Dexmedetomidine - adverse effects
Drug abuse
Female
Fever
Fever - chemically induced
Heart surgery
Hospitals
Humans
Hyperthermia
Inflammation
Intensive care
Intensive Care Units
Male
Medical records
Middle Aged
Multivariate analysis
Obesity
Patients
Retrospective Studies
Sepsis
Time Factors
Australia
anaesthesia and intensive care
dexmedetomidine
hyperthermia
intensive care
sedation
pharmacology
dexmedetomidine, anaesthesia and intensive care, pharmacology, hyperthermia, intensive care, sedation
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Summary:Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature >=39.5 degreesC, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia. Temperature data was available for 9,782 ICU admissions. Dexmedetomidine was given intravenously to 611 (6.3%) patients at a dose of 0 to 1.5 g/kg/hour. Temperatures >=39.5 degreesC were recorded in 341 (3.5%) patients. Overall hospital mortality was 10.8% for all admissions and 29.3% for patients with temperatures >=39.5 degreesC. Dexmedetomidine exposure was more frequent in patients with temperature recordings >=39.5 degreesC compared to those with temperatures <39.5 degreesC, 11.94% versus 2.94% (odds ratio [OR] 4.49; 95% confidence intervals [CI] 3.37, 5.92; P <0.001). The association was stronger for patients post-open heart surgery (OHS) with temperatures >=39.5 degreesC (OR 12.9; 95% CI 5.01, 31.62; P <0.001). Multivariate analysis showed an independent association between dexmedetomidine and a temperature >=39.5 degreesC in two particular patient groups: OHS (OR 2.72; 95% CI 1.1, 6.9; P <0.001), and obesity (OR 3.44; 95% CI 1.5, 7.9; P <0.001). Dexmedetomidine exposure is associated with an increased risk of hyperthermia. Possible risk factors are open heart surgery and obesity.
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Anaesthesia and Intensive Care, Vol. 45, No. 6, Nov 2017: 727-736
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X1704500613