Identification of risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation

Dexmedetomidine may cause hypertension and tachycardia upon discontinuation. Risk factors are poorly described but may include prolonged infusion, higher doses, a history of hypertension, and abrupt cessation. This study aims to identify risk factors for hypertension and tachycardia upon dexmedetomi...

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Bibliographic Details
Published in:Journal of critical care 2020-10, Vol.59, p.81-85
Main Authors: Salah, Jamal, Grgurich, Philip, Nault, Katharine, Lei, Yuxiu
Format: Article
Language:English
Subjects:
Adrenergic receptors
Anesthesia
Antihypertensives
Cardiac arrhythmia
Critical care
Dexmedetomidine discontinuation
Dexmedetomidine withdrawal
Ethnicity
Hypertension
Patients
Regression analysis
Risk factors
Sedation
Tachycardia
Variables
Ventilators
Weaning
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Summary:Dexmedetomidine may cause hypertension and tachycardia upon discontinuation. Risk factors are poorly described but may include prolonged infusion, higher doses, a history of hypertension, and abrupt cessation. This study aims to identify risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation. In this single-center, case-control study, critically ill patients requiring dexmedetomidine for 6 h or more were screened for hypertension or tachycardia within 24 h of discontinuation. We compared baseline and dexmedetomidine-specific data between patients who developed hypertension or tachycardia (cases) and those who did not (controls) and used logistic regression to identify independent risk factors. Of 110 patients, 35 (31.8%) experienced hypertension or tachycardia. When comparing cases to controls, the maximum dexmedetomidine dose was 0.7 and 0.75 μg/kg/h (p = .54), cumulative dose was 1174.5 and 1063.5 μg/kg/h (p = .43), and duration was 31and 23.25 h (p = .22), respectively. Only a past medical history of hypertension was an independent predictor of hypertension or tachycardia upon dexmedetomidine discontinuation. Approximately one third of patients experienced hypertension or tachycardia upon dexmedetomidine discontinuation. A past medical history of hypertension was the only independent risk factor identified in this study based on the clinical data collected. •Risk factors for rebound hypertension or tachycardia with dexmedetomidine•History of hypertension may be a risk factor for dexmedetomidine withdrawal•Accounting for confounding variables in analysis of risk factors of dexmedetomidine withdrawal
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2020.06.006