Prolonged use of dexmedetomidine in an infant with respiratory failure following living donor liver transplantation
| Autor: | Takashi Saito, Taro Mizutani, Tetsuo Hori, Michio Kaneko, Yuki Enomoto, Akira Matsui, Toyoichiro Kudo |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Critical Care medicine.medical_treatment Sedation Liver transplantation Fentanyl Intensive care Living Donors medicine Humans Hypnotics and Sedatives Anesthesia Dexmedetomidine Mechanical ventilation business.industry Infant Respiration Artificial Liver Transplantation Surgery Anesthesiology and Pain Medicine Respiratory failure Pediatrics Perinatology and Child Health Midazolam medicine.symptom Respiratory Insufficiency business medicine.drug |
| Zdroj: | Pediatric Anesthesia. 16:1285-1288 |
| ISSN: | 1460-9592 1155-5645 |
| DOI: | 10.1111/j.1460-9592.2006.02008.x |
| Popis: | We used dexmedetomidine for more than 2 months in a mechanically ventilated infant without serious adverse effects. An infant with liver cirrhosis of unknown cause underwent living donor liver transplantation at the age of 9 months. Long-term mechanical ventilation was required postoperatively, and midazolam with fentanyl had been used to sedate the patient. They required increase to 1.7 mg.kg(-1).h(-1) and 3.5 microg.kg(-1).h(-1), respectively, which were still inadequate. On postoperative day 29, dexmedetomidine was added. The rate of dexmedetomidine infusion was increased gradually to 1.4 microg.kg(-1).h(-1). It was discontinued temporarily to exclude drug-induced liver dysfunction. However, without dexmedetomidine, adequate sedation level was unattainable. Liver dysfunction was likely to be attributed to cytomegalovirus infection and after restarting dexmedetomidine, the respiratory condition improved. He was extubated 10 weeks after the operation. Dexmedetomidine was successfully tapered off over the following 2 weeks with no signs of withdrawal. Dexmedetomidine was a useful sedative for an infant who required mechanical ventilation for a prolonged period of time. |
| Databáze: | OpenAIRE |
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