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Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study

OBJECTIVE: To determine a safe dose of clonidine (CLON) to be used in infants with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). STUDY DESIGN: A pilot prospective study was performed to determine the effect of CLON on autonomic parameters, the pharmacokinetics (PK) o...

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Autores principales: Gauda, Estelle B, Chavez-Valdez, Raul, Northington, Frances J, Lee, Carlton KK, Rudek, Michelle A, Guglieri-Lopez, Beatriz, Ivaturi, Vijay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8917970/
https://www.ncbi.nlm.nih.gov/pubmed/34531532
http://dx.doi.org/10.1038/s41372-021-01151-1
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author Gauda, Estelle B
Chavez-Valdez, Raul
Northington, Frances J
Lee, Carlton KK
Rudek, Michelle A
Guglieri-Lopez, Beatriz
Ivaturi, Vijay
author_facet Gauda, Estelle B
Chavez-Valdez, Raul
Northington, Frances J
Lee, Carlton KK
Rudek, Michelle A
Guglieri-Lopez, Beatriz
Ivaturi, Vijay
author_sort Gauda, Estelle B
collection PubMed
description OBJECTIVE: To determine a safe dose of clonidine (CLON) to be used in infants with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). STUDY DESIGN: A pilot prospective study was performed to determine the effect of CLON on autonomic parameters, the pharmacokinetics (PK) of CLON, and the amount of morphine (MOR) given “as needed” for shivering and agitation in a cohort of infants (n=12) with HIE undergoing TH compared to a historical control group (n=28). RESULTS: The CLON group received less “as needed” MOR than the MOR-only group for agitation/shivering (p < 0.001), and the CLON vs MOR-only group spent 92% vs 79% of cooling time at the target core body temperature (CBT; p = 0.03, CLON vs MOR). CONCLUSIONS: Intravenous CLON (1mcg/kg Q8h) is well tolerated in infants treated with TH for HIE. CLON stabilizes CBT in the ideal range during cooling which may be optimal for neuroprotection.
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spelling pubmed-89179702022-03-16 Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study Gauda, Estelle B Chavez-Valdez, Raul Northington, Frances J Lee, Carlton KK Rudek, Michelle A Guglieri-Lopez, Beatriz Ivaturi, Vijay J Perinatol Article OBJECTIVE: To determine a safe dose of clonidine (CLON) to be used in infants with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). STUDY DESIGN: A pilot prospective study was performed to determine the effect of CLON on autonomic parameters, the pharmacokinetics (PK) of CLON, and the amount of morphine (MOR) given “as needed” for shivering and agitation in a cohort of infants (n=12) with HIE undergoing TH compared to a historical control group (n=28). RESULTS: The CLON group received less “as needed” MOR than the MOR-only group for agitation/shivering (p < 0.001), and the CLON vs MOR-only group spent 92% vs 79% of cooling time at the target core body temperature (CBT; p = 0.03, CLON vs MOR). CONCLUSIONS: Intravenous CLON (1mcg/kg Q8h) is well tolerated in infants treated with TH for HIE. CLON stabilizes CBT in the ideal range during cooling which may be optimal for neuroprotection. 2022-03 2021-09-16 /pmc/articles/PMC8917970/ /pubmed/34531532 http://dx.doi.org/10.1038/s41372-021-01151-1 Text en Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms
spellingShingle Article
Gauda, Estelle B
Chavez-Valdez, Raul
Northington, Frances J
Lee, Carlton KK
Rudek, Michelle A
Guglieri-Lopez, Beatriz
Ivaturi, Vijay
Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
title Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
title_full Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
title_fullStr Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
title_full_unstemmed Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
title_short Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
title_sort clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8917970/
https://www.ncbi.nlm.nih.gov/pubmed/34531532
http://dx.doi.org/10.1038/s41372-021-01151-1
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