Evaluation of the Safety of Dexmedetomidine Dosing Utilizing Adjusted Body Weight in Obese Critically Ill Patients: A Retrospective Study

TL;DR

This study found that using adjusted body weight to dose dexmedetomidine in obese critically ill patients may be safer, with fewer heart rate drops.

Contribution

The study evaluates the safety of using adjusted body weight for dexmedetomidine dosing in obese critical care patients.

Findings

Dosing with adjusted body weight showed lower hypotension and bradycardia, though not statistically significant.

Adjusted body weight dosing led to a significantly higher lowest heart rate compared to actual body weight dosing.

No significant difference in lowest mean arterial pressure was observed between the two dosing methods.

Abstract

The purpose of this study was to evaluate the safety of dexmedetomidine dosing, utilizing adjusted body weight (AdjBW) in obese, critically ill patients. This was a retrospective cohort study of patients who received dexmedetomidine from March 2020 to April 2021. Participants received dexmedetomidine as the sole agent for sedation for ≥8 hours, were ≥18 years old, had a level of care listed as “critical care,” and had an actual body weight (ABW) of at least 120% of their ideal body weight (IBW). A total of 225 participants were included. Results demonstrated that the incidence of hypotension and bradycardia was lower in the AdjBW group compared to the ABW group, but this did not reach statistical significance. Dosing dexmedetomidine based on AdjBW, instead of ABW, resulted in a statistically significant difference in the lowest recorded heart rate, with 61.2 ± 11.8 bpm in the ABW group and 65.2 ± 14.7 bpm in the AdjBW group (p = 0.027). Dosing dexmedetomidine based on AdjBW did not show statistically significant differences in the lowest recorded mean arterial pressure (MAP). Using AdjBW to dose dexmedetomidine appears to be safe in this patient population.