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Dexmedetomidine reduces shivering during mild hypothermia in waking subjects

Callaway, CW and Elmer, J and Guyette, FX and Molyneaux, BJ and Anderson, KB and Empey, PE and Gerstel, SJ and Holquist, K and Repine, MJ and Rittenberger, JC (2015) Dexmedetomidine reduces shivering during mild hypothermia in waking subjects. PLoS ONE, 10 (8).

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Abstract

© 2015 Callaway et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background and Purpose Reducing body temperature can prolong tolerance to ischemic injury such as stroke or myocardial infarction, but is difficult and uncomfortable in awake patients because of shivering. We tested the efficacy and safety of the alpha-2-adrenergic agonist dexmedetomidine for suppressing shivering induced by a rapid infusion of cold intravenous fluids. Methods Ten subjects received a rapid intravenous infusion of two liters of cold (4°C) isotonic saline on two separate test days, and we measured their core body temperature, shivering, hemodynamics and sedation for two hours. On one test day, fluid infusion was preceded by placebo infusion. On the other test day, fluid infusion was preceded by 1.0 μg/kg bolus of dexmedetomidine over 10 minutes. Results All ten subjects experienced shivering on placebo days, with shivering beginning at a mean (SD) temperature of 36.6 (0.3)°C. The mean lowest temperature after placebo was 36.0 (0.3) °C (range 35.7-36.5°C). Only 3/10 subjects shivered on dexmedetomidine days, and the mean lowest temperature was 35.7 (0.4) °C (range 35.0-36.3°C). Temperature remained below 36°C for the full two hours in 6/10 subjects. After dexmedetomidine, subjects had moderate sedation and a mean 26 (13) mmHg reduction in blood pressure that resolved within 90 minutes. Heart rate declined a mean 23 (11) bpm after both placebo and dexmedetomidine. Dexmedetomidine produced no respiratory depression. Conclusion Dexmedetomidine decreases shivering in normal volunteers. This effect is associated with decreased systolic blood pressure and sedation, but no respiratory depression. Copyright:


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Callaway, CWcallaway@pitt.eduCALLAWAY
Elmer, J
Guyette, FXfxg2@pitt.eduFXG2
Molyneaux, BJMOLY@pitt.eduMOLY
Anderson, KBkaa66@pitt.eduKAA66
Empey, PEpempey@pitt.eduPEMPEY
Gerstel, SJ
Holquist, K
Repine, MJ
Rittenberger, JC
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorLazzeri, ChiaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 3 August 2015
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: PLoS ONE
Volume: 10
Number: 8
DOI or Unique Handle: 10.1371/journal.pone.0129709
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Critical Care Medicine
School of Medicine > Emergency Medicine
School of Pharmacy > Pharmaceutical Sciences
Refereed: Yes
Date Deposited: 23 Aug 2016 14:26
Last Modified: 04 Feb 2019 15:58
URI: http://d-scholarship.pitt.edu/id/eprint/28409

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