Fever arises in ICU patients with greater infusion rate, duration of dexmedetomidine

A few patients in the intensive care unit (ICU) on dexmedetomidine therapy develop fever >38.5 °C, reveals a recent study. Higher infusion rate and longer duration of treatment are significantly associated with the fever.

“Published literature has described the temporal relationship of dexmedetomidine with elevated temperatures,” the researchers said, who then set out to estimate the incidence of fever greater than or equal to 38.5 °C in ICU patients receiving dexmedetomidine in a retrospective cohort study.

A total of 882 ICU patients aged ≥18 years admitted between November 2017 and August 2018 who received continuous dexmedetomidine for 6 or more hours were identified in this study, with a propensity-matched subgroup analysis comparing fever to nonfever patients.

Eligible participants who developed a fever of at least 38.5 °C while on dexmedetomidine were determined as having dexmedetomidine-related fever, the primary outcome.

A total of 404 ICU patients on dexmedetomidine were eligible for inclusion, of whom 61 (15.1 percent) met the definition for the primary outcome, whereas 42 who received the study drug but did not develop fever were matched for multivariate analysis.

ICU patients with 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 who did not develop a fever.

“Fever greater than 38.5°C was observed in 15.1 percent of ICU patients while receiving dexmedetomidine,” the researchers said. “Prospective studies are warranted to validate these findings.”