Dexmedetomidine:
Intravenous, alpha-2 agonist
ECMO Dose Adjustment:
YES—an increased dose may be warranted in some patients.
Renal Impairment Dose Adjustment:
NONE
CRRT Dose Adjustment:
NONE
Hepatic Impairment Dose Adjustment:
NONE
Adult Starting Dose^:
Adult Continuous Infusion: 0.2-0.4 mcg/kg/hr
Pediatric Starting Dose^:
Pediatric Continuous Infusion: 0.3-0.5 mcg/kg/hr
Neonatal Starting Dose^:
Neonatal Continuous Infusion: 0.3-0.5 mcg/kg/hr
^Always use the lowest effect dose to an objective endpoint (e.g., sedation scale).
Intravenous sedative physicochemical and pharmacokinetic characteristics
Drug Dexmedetomidine
   
Onset (min) 5-15
Log P 2.8
Protein Binding (%) 94-97
Metabolism / Elimination Hepatic
Dose Adjustment on ECMO ++
Dose Range*
Adult: 0.2-2.5 mcg/kg/hr
Pediatric: 0.5-2.5 mcg/kg/hr
Neonatal: 0.5-2.5 mcg/kg/hr
- Minimal sequestration; no need for Dose Adjustment
++ Moderate sequestration; may require Dose Adjustment
+++ Significant sequestration; need for Dose Adjustment
*Titrate to patient-specific goals, using the lowest effective dose. Dose ranges represent doses typically used in clinical practice; in some situations, patients may require doses above the usual dose range to achieve patient-specific goals.