High-dose Dexmedetomidine-induced Hypertension in a Child with Traumatic Brain Injury

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Dexmedetomidine is a centrally acting α2-adrenergic agonist which is currently FDA-approved for the short-term (less than 24 h) sedation of adults during mechanical ventilation.


Given its beneficial physiologic properties, there has been increasing use of this agent in the pediatric population. As with any agent used for sedation in the Pediatric ICU setting, dose escalations may be necessary. Unlike benzodiazepines and opioids, there are limited data regarding the administration of dexmedetomidine above the current package insert dosing recommendations of 0.7 μg/kg/h.


We report a 2-year-old child with traumatic brain injury who developed hypertension following the administration of a dexmedetomidine infusion at 4 μg/kg/h for several hours. Investigation into the etiology of the hypertension was negative and the blood pressure returned to baseline with a decrease in the infusion rate.


Subsequent to this, no further issues with hypertension were noted.

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