933: Dexmedetomidine-Induced Fever in a Morbidly Obese Critically Ill Patient

Oh, E.S.; Gupte, Chaitali; Shah, Chirag V.; Adamczyk, Katarzyna

doi:10.1097/01.ccm.0000551682.13384.8f

Cited by 2 publications

(2 citation statements)

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“…Obesity was found to have an odds ratio of 3.44 (95%CI, 1.5-7.9) for dexmedetomidine-associated hyperthermia. 44 Of the 12 individual case reports identified by this systematic review, obesity was identified in 4, 8,25,26,30 whereas the remaining 8 did not report BMI, weight, or obese status. Inflammation associated with obesity is a well-established phenomenon, and hypothalamic inflammation may be linked with obesity as well.…”

Section: Discussionmentioning

confidence: 99%

“…Study characteristics including quality of evidence and risk of bias are summarized in Table 2. 8,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] The majority of reports were case reports/series with few retrospective cohort studies. There were no high-quality randomized, controlled trials identified through systematic review.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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Fever Associated With Dexmedetomidine in Adult Acute Care Patients: A Systematic Review of the Literature

Schurr

Ambrosi

Lastra

et al. 2021

The Journal of Clinical Pharma

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Dexmedetomidine‐associated fever has been reported in the literature and can lead to lengthy workups and unnecessary antibiotic exposure. We conducted a systematic review to evaluate and describe the evidence of fever or hyperthermia caused by dexmedetomidine in adult patients. Data sources included PubMed/MEDLINE, EMBASE, CINAHL, and Web of Sciences. English‐language studies of any design published from inception through April 2020 including conference abstracts were included. The target population was hospitalized adult patients. Quality of evidence was determined based on GRADE recommendations and risk of bias assessed using the Evidence Project Risk of Bias tool. Naranjo scores were assessed to determine the likeliness of adverse event being caused by dexmedetomidine. All data were extracted independently and with the guidance of a medical librarian. Four hundred and eighty‐eight total citations were found on formal search, with 329 left after removal of duplicates. Independent record screening was performed, leaving 17 citations including 4 retrospective cohort studies, 1 case series, and 12 case reports. Quality of evidence ranged from very low to low for identified analyses. Evidence with patient‐level data (case reports and series) were combined to establish a cohort for descriptive results. The median Naranjo score was 4 (range, 3 to 8), and dexmedetomidine doses ranged from 0.1 to 2 μg·h/kg. Obesity and cardiac surgery appear to be significant risk factors. Dexmedetomidine‐associated fever appears uncommon, but the true incidence is unknown. Clinicians should keep dexmedetomidine‐associated fever in their differential, and stewardship programs should consider assessing for this adverse effect in their patient monitoring.

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