Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases

Abstract Background Dexmedetomidine use in neonatal units is increasing. Data on its safety are still limited. There are no previous reports of clinical presentation of dexmedetomidine overdose in newborns. Case presentation Three babies simultaneously developed a similar clinical picture of recurre...

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Main Authors: Giulia Paviotti, Mariabeatrice D’Agostini, Isabella Mauro, Federica Bortolotti, Rossella Gottardo, Carla Pittini
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-02060-1
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author Giulia Paviotti
Mariabeatrice D’Agostini
Isabella Mauro
Federica Bortolotti
Rossella Gottardo
Carla Pittini
author_facet Giulia Paviotti
Mariabeatrice D’Agostini
Isabella Mauro
Federica Bortolotti
Rossella Gottardo
Carla Pittini
author_sort Giulia Paviotti
collection DOAJ
description Abstract Background Dexmedetomidine use in neonatal units is increasing. Data on its safety are still limited. There are no previous reports of clinical presentation of dexmedetomidine overdose in newborns. Case presentation Three babies simultaneously developed a similar clinical picture of recurrent apneas, a typical “gasping” breathing pattern, irritability followed by hypotonia and hyporeactivity, hyperglycaemia, hypocapnia, increase in lactates and a suppression-burst pattern on CFM/EEG. Babies required intubation and mechanical ventilation due to poor respiratory effort. Symptoms resolved completely in a few hours. Dexmedetomidine was administered enterally by a nasogastric tube in place of caffeine due to “look alike” medication error. Dexmedetomidine was retrieved in biological samples. Babies were developing regularly at post-discharge follow up visits. Conclusion Dexmedetomidine overdose due to medication error is possible in newborns and should be suspected in case of clinical presentations similar to the one we reported. Measures should be implemented in neonatal units for a safe use of dexmedetomidine.
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issn 1824-7288
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publishDate 2025-07-01
publisher BMC
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series Italian Journal of Pediatrics
spelling doaj-art-36e63a3b883f4ed48a36c17dd3d595472025-08-20T04:02:55ZengBMCItalian Journal of Pediatrics1824-72882025-07-015111710.1186/s13052-025-02060-1Accidental dexmedetomidine overdose in preterm newborns: a report of 3 casesGiulia Paviotti0Mariabeatrice D’Agostini1Isabella Mauro2Federica Bortolotti3Rossella Gottardo4Carla Pittini5Division of Neonatology, University Hospital of UdineDepartment of Medicine-DMed, University of UdineDivision of Neonatology, University Hospital of UdineDepartment of Diagnostic and Public Health, Unit of Forensic Medicine, University of VeronaDepartment of Diagnostic and Public Health, Unit of Forensic Medicine, University of VeronaDivision of Neonatology, University Hospital of UdineAbstract Background Dexmedetomidine use in neonatal units is increasing. Data on its safety are still limited. There are no previous reports of clinical presentation of dexmedetomidine overdose in newborns. Case presentation Three babies simultaneously developed a similar clinical picture of recurrent apneas, a typical “gasping” breathing pattern, irritability followed by hypotonia and hyporeactivity, hyperglycaemia, hypocapnia, increase in lactates and a suppression-burst pattern on CFM/EEG. Babies required intubation and mechanical ventilation due to poor respiratory effort. Symptoms resolved completely in a few hours. Dexmedetomidine was administered enterally by a nasogastric tube in place of caffeine due to “look alike” medication error. Dexmedetomidine was retrieved in biological samples. Babies were developing regularly at post-discharge follow up visits. Conclusion Dexmedetomidine overdose due to medication error is possible in newborns and should be suspected in case of clinical presentations similar to the one we reported. Measures should be implemented in neonatal units for a safe use of dexmedetomidine.https://doi.org/10.1186/s13052-025-02060-1DexmedetomidineMedication errorNewbornOverdoseCase report
spellingShingle Giulia Paviotti
Mariabeatrice D’Agostini
Isabella Mauro
Federica Bortolotti
Rossella Gottardo
Carla Pittini
Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases
Italian Journal of Pediatrics
Dexmedetomidine
Medication error
Newborn
Overdose
Case report
title Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases
title_full Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases
title_fullStr Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases
title_full_unstemmed Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases
title_short Accidental dexmedetomidine overdose in preterm newborns: a report of 3 cases
title_sort accidental dexmedetomidine overdose in preterm newborns a report of 3 cases
topic Dexmedetomidine
Medication error
Newborn
Overdose
Case report
url https://doi.org/10.1186/s13052-025-02060-1
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