Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl
Purpose. To report a case series of three patients who developed significant bradycardia while receiving the combination of dexmedetomidine and fentanyl for sedation and analgesia. Materials and Methods. This is a case series of patients obtained from a mixed medical, surgical, and cardiac ICU in a...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2017/4504207 |
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| _version_ | 1832551728692592640 |
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| author | Channing Hui Maria Cardinale Balaji Yegneswaran |
| author_facet | Channing Hui Maria Cardinale Balaji Yegneswaran |
| author_sort | Channing Hui |
| collection | DOAJ |
| description | Purpose. To report a case series of three patients who developed significant bradycardia while receiving the combination of dexmedetomidine and fentanyl for sedation and analgesia. Materials and Methods. This is a case series of patients obtained from a mixed medical, surgical, and cardiac ICU in a community teaching hospital. Three intubated patients receiving fentanyl and dexmedetomidine infusion developed sudden bradycardia requiring intervention. In all three cases, adjustments to therapy were required. Results. All three patients experienced significant bradycardia, with a heart rate less than 50 bpm, and one patient briefly developed asystole. In Case 1, the fentanyl infusion rate was reduced by 67% and the dexmedetomidine infusion rate was reduced by 25%. In Case 2, the sedation was changed to midazolam, and in Case 3, both fentanyl and dexmedetomidine were discontinued. In all three cases, there were no further incidences of significant bradycardia following intervention. Conclusions. Fentanyl used in combination with dexmedetomidine can result in clinically significant bradycardia. Further study is warranted to identify risk factors and elucidate the mechanisms that result in life-threatening bradycardia. |
| format | Article |
| id | doaj-art-39e84d4774c64fbbb12e24d8a0221a93 |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-39e84d4774c64fbbb12e24d8a0221a932025-02-03T06:00:40ZengWileyCase Reports in Critical Care2090-64202090-64392017-01-01201710.1155/2017/45042074504207Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and FentanylChanning Hui0Maria Cardinale1Balaji Yegneswaran2Rutgers-Robert Wood Johnson Medical School, Department of Emergency Medicine, One Robert Wood Johnson Place, MEB 389, New Brunswick, NJ 08901, USAErnest Mario School of Pharmacy, Rutgers University, 160 Frelinghuysen Rd., Piscataway Township, NJ 08854, USASaint Peter’s University Hospital, 254 Easton Ave., New Brunswick, NJ 08901, USAPurpose. To report a case series of three patients who developed significant bradycardia while receiving the combination of dexmedetomidine and fentanyl for sedation and analgesia. Materials and Methods. This is a case series of patients obtained from a mixed medical, surgical, and cardiac ICU in a community teaching hospital. Three intubated patients receiving fentanyl and dexmedetomidine infusion developed sudden bradycardia requiring intervention. In all three cases, adjustments to therapy were required. Results. All three patients experienced significant bradycardia, with a heart rate less than 50 bpm, and one patient briefly developed asystole. In Case 1, the fentanyl infusion rate was reduced by 67% and the dexmedetomidine infusion rate was reduced by 25%. In Case 2, the sedation was changed to midazolam, and in Case 3, both fentanyl and dexmedetomidine were discontinued. In all three cases, there were no further incidences of significant bradycardia following intervention. Conclusions. Fentanyl used in combination with dexmedetomidine can result in clinically significant bradycardia. Further study is warranted to identify risk factors and elucidate the mechanisms that result in life-threatening bradycardia.http://dx.doi.org/10.1155/2017/4504207 |
| spellingShingle | Channing Hui Maria Cardinale Balaji Yegneswaran Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl Case Reports in Critical Care |
| title | Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl |
| title_full | Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl |
| title_fullStr | Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl |
| title_full_unstemmed | Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl |
| title_short | Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl |
| title_sort | significant bradycardia in critically ill patients receiving dexmedetomidine and fentanyl |
| url | http://dx.doi.org/10.1155/2017/4504207 |
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