Dexmedetomidine-Associated Hyperpyrexia in Three Critically Ill Patients With Coronavirus Disease 2019.
Crit Care Explor
; 2(9): e0213, 2020 Sep.
Article
in English
| MEDLINE | ID: covidwho-801046
ABSTRACT
OBJECTIVES:
To present three patients with severe coronavirus disease 2019 infection who developed life-threatening hyperpyrexia while being treated with dexmedetomidine for sedation. DATA SOURCES Clinical records. STUDY SELECTION Case report. DATA EXTRACTION Relevant clinical information. DATASYNTHESIS:
We describe three patients, a 60-year-old female, 43-year-old female, and 46-year-old male, who were hospitalized in surge ICUs during the coronavirus disease 2019 pandemic in the early spring of 2020. All developed hyperpyrexia, defined as a temperature above 41.1°C, following an increase in dexmedetomidine dosing to above 1.5 µg/kg/hr. Fevers resolved following discontinuation of dexmedetomidine.CONCLUSIONS:
While the exact mechanism of hyperpyrexia remains unclear, findings in this study suggest that high doses of dexmedetomidine infusion are associated with hyperpyrexia in a seemingly dose-dependent fashion in critically ill patients with coronavirus disease 2019. Coronavirus disease 2019 infection causes a hyperinflammatory state characterized by pro-inflammatory cytokine dysregulation. Dexmedetomidine, a centrally acting alpha-2 agonist, may alter hypothalamic temperature regulation through disturbances in neurotransmitter expression and metabolism. We postulate that the use of high-dose dexmedetomidine in a hyperinflammatory state may increase the risk of developing hyperpyrexia in this severe disease state.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
/
Prognostic study
/
Reviews
Language:
English
Journal:
Crit Care Explor
Year:
2020
Document Type:
Article
Affiliation country:
Cce.0000000000000213
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