Dexmedetomidine, an α2-adrenergic agonist, can be used to perform mild to moderate sedation in critically ill patients. In this case series, 9 cardiovascular intensive care unit patients with hyperthermia during dexmedetomidine administration, suggestive of drug fever, are presented. Hyperthermia (>38.5°C) occurred 6 (4–10) hours (median [interquartile range]) after dexmedetomidine initiation at a dose of 1.0 (0.8–1.3) μg/kg/h and was resolved 3 (1–8) hours after discontinuation of dexmedetomidine. All patients were screened for infectious and noninfectious causes of hyperthermia, and the findings were analyzed by 2 adverse drug reaction (ADR) assessment methods—the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) Causality Assessment and the Naranjo ADR scale. This resulted in a “probable” ADR in all 9 patients (WHO) and a “probable” and “possible” ADR in 1 and 8 patients (Naranjo), respectively. This case series supports published case reports, suggesting that dexmedetomidine administration may be associated with the occurrence of clinically relevant hyperthermia. The underlying mechanisms and risk factors are uncertain and require further research.
Supplemental Digital Content is available in the text.Published ahead of print July 28, 2017.
From the *Intensive Care Unit for Cardiovascular Surgery, Institute of Anaesthesiology, University of Zurich, and University Hospital Zurich, Zurich, Switzerland; and †Unit of General Internal Medicine, Hirslanden Clinic, Zurich, Switzerland.
Published ahead of print July 28, 2017.
Accepted for publication June 9, 2017.
Conflicts of Interest: See Disclosures at the end of the article.
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B. D. Krüger and J. Kurmann are equally contributing first authors.
D. Bettex and A. Rudiger are equally contributing last authors.
All investigators met all 4 criteria for authorship according to the recommendations of the International Committee of Medical Journal Editors (ICMJE).
Reprints will not be available from the authors.
Address correspondence to Alain Rudiger, MD, Cardio-surgical Intensive Care Unit, Institute of Anaesthesiology, University of Zurich and University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland. Address e-mail to email@example.com.