• Kim E Grayson, Michael Bailey, Mayurathan Balachandran, Piyusha P Banneheke, Alessandro Belletti, Rinaldo Bellomo, Thummaporn Naorungroj, Ary Serpa-Neto, Jason D Wright, Fumitaka Yanase, Paul J Young, and Yahya Shehabi.
• Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
• Crit. Care Med. 2021 Jul 1; 49 (7): 1118-1128.

ObjectivesPrevious case series reported an association between dexmedetomidine use and hyperthermia. Temperature data have not been systematically reported in previous randomized controlled trials evaluating dexmedetomidine. A causal link between dexmedetomidine administration and elevated temperature has not been demonstrated.DesignPost hoc analysis.SettingFour ICUs in Australia and New Zealand.PatientsAbout 703 mechanically ventilated ICU patients.InterventionsEarly sedation with dexmedetomidine versus usual care.Measurements And Main ResultsThe primary outcome was mean daily body temperature. Secondary outcomes included the proportions of patients with body temperatures greater than or equal to 38.3°C and greater than or equal to 39°C, respectively. Outcomes were recorded for 5 days postrandomization in the ICU. The mean daily temperature was not different between the dexmedetomidine (n = 351) and usual care (n = 352) groups (36.84°C ± sd vs 36.78°C ± sd; p = 0.16). Over the first 5 ICU days, more dexmedetomidine group (vs usual care) patients had a temperature greater than or equal to 38.3°C (43.3% vs 32.7%, p = 0.004; absolute difference 10.6 percentage points) and greater than or equal to 39.0°C (19.4% vs 12.5%, p = 0.013; absolute difference 6.9 percentage points). Results were similar after adjusting for diagnosis, admitting temperature, age, weight, study site, sepsis occurrence, and the time from dexmedetomidine initiation to first hyperthermia recorded. There was a significant dose response relationship with temperature increasing by 0.30°C ±0.08 for every additional 1 μg/kg/hr of dexmedetomidine received p < 0.0002.ConclusionsOur study suggests potentially important elevations in body temperature are associated with early dexmedetomidine sedation, in adults who are mechanically ventilated in the ICU.Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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