Dexmedetomidine-related fever seen in some adult ICU patients

A few patients in the intensive care unit (ICU) have registered a fever >38.5 °C while on dexmedetomidine therapy, reports a recent study.

“Published literature has described the temporal relationship of dexmedetomidine with elevated temperatures, but there is limited data to quantify the incidence of fever in ICU patients receiving dexmedetomidine,” the researchers said.

To address the lack of data, a retrospective cohort study was carried out on ICU patients who received dexmedetomidine with a propensity-matched subgroup analysis comparing dexmedetomidine fever patients to nonfever counterparts.

Patients aged ≥18 years who had been admitted between November 2017 and August 2018 and received continuous dexmedetomidine for ≥6 hours were included in the study. Eligible participants with a temperature ≥38.5 °C while receiving dexmedetomidine were recognized as having dexmedetomidine-related fever.

A total of 882 ICU patients were assessed, of which 404 dexmedetomidine patients were included in the analysis. Sixty-one of them (15.1 percent) met the definition for the primary endpoint, while 42 who received dexmedetomidine but did not develop a fever were matched for multivariate analysis.

Patients who developed a fever received a higher mean maximum infusion rate (0.98 vs 0.68 µg/kg/h; p<0.001) and a longer median duration of dexmedetomidine (43.0 vs 24.3 hours; p=0.001) compared to those in the nonfever group.

“Prospective studies are warranted to validate these findings,” the researchers said.