In this episode, I’ll discuss early dexmedetomidine use and body temperature elevation.
Dexmedetomidine has previously been identified as a cause of drug fever in the ICU in case reports, and in my practice, this has seemingly come up often.
Investigators recently published a post-hoc analysis of body temperature elevations from a multi-center randomized trial that looked at early sedation with dexmedetomidine versus usual care.
While mean daily temperature was not different between the dexmedetomidine and the usual care group, a significant number of dexmedetomidine patients had a temperature greater than 38.3 degrees C as well as 39 degrees C. These results were similar when potential confounders were adjusted for. Finally, there was a statistically significant dose-response relationship identified where body temperature increased by 0.30°Cfor every additional 1 μg/kg/hr of dexmedetomidine given.
This post-hoc analysis is as close to a causal relationship for dexmedetomidine and drug fever as will probably ever be identified, as a prospective randomized trial just looking at temperature elevations is unlikely to be published.
While this information is helpful to identify dexmedetomidine as a cause of drug-related fever, it is unknown whether there is any adverse clinical effect of these temperature elevations.
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