Dexmedetomidine use raises body temp in ICU patients with obesity

Critically ill patients with obesity see a significant rise in their body temperature following the use of dexmedetomidine (DEX) for ongoing sedation, as shown in a recent study. Furthermore, DEX duration and baseline temperature are significantly associated with fever development in these individuals.

Previous studies reported an association between hyperthermia and DEX use for ongoing sedation in nonobese patients. The present single-centre, retrospective, cohort study sought to evaluate the effect of DEX on temperature in critically ill, obese patients. 

A group of researchers evaluated patients aged ≥18 years who had been admitted to a surgical or medical intensive care unit (ICU), received DEX for ≥8 hours as a single continuous infusion sedative, and weighed ≥120 percent of the ideal body weight. They excluded those with fever (≥38 °C) and positive cultures within 48 hours of DEX initiation.

In total, 186 critically ill patients with obesity were included in the analysis. Of these, 42 (22.5 percent) had a fever during the first 48 hours of DEX initiation. No difference was seen in the median weight between the febrile and afebrile groups (99.4 vs 97.6 kg; p=0.6). The median change from baseline temperature for all patients within 48 hours was an increase of 0.5 °C (p<0.001).

Duration of DEX (adjusted odds ratio [aOR], 1.041, 95 percent confidence interval [CI], 1.009‒1.074; p=0.012) and baseline temperature (aOR, 7.058, 95 percent CI, 3.307‒15.064; p<0.001) were the only factors that correlated significantly with fever development in multiple regression analysis.

“Further studies are warranted,” according to the researchers.