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Dexmedetomidine-Associated Hyperpyrexia in Three Critically Ill Patients With Coronavirus Disease 2019
| Content Provider | Scilit |
|---|---|
| Author | Czepiel, Kathryn S. Lucas, Alexandra T. Whalen, Michael J. Mojica, James E. |
| Copyright Year | 2020 |
| Description | Journal: Critical Care Explorations 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. Data Synthesis: 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. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498133/pdf |
| ISSN | 26398028 |
| e-ISSN | 26398028 |
| DOI | 10.1097/cce.0000000000000213 |
| Journal | Critical Care Explorations |
| Issue Number | 9 |
| Volume Number | 2 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2020-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Critical Care Explorations Critical Care Medicine Coronavirus Disease 2019, Covid-19, Dexmedetomidine, Hyperpyrexia, Severe Acute Respiratory Syndrome Coronavirus 2 |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine |
