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10.1097/CCE.0000000000000213

http://scihub22266oqcxt.onion/10.1097/CCE.0000000000000213
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32984835!7498133!32984835
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suck abstract from ncbi


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pmid32984835      Crit+Care+Explor 2020 ; 2 (9): e0213
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  • Dexmedetomidine-Associated Hyperpyrexia in Three Critically Ill Patients With Coronavirus Disease 2019 #MMPMID32984835
  • Czepiel KS; Lucas AT; Whalen MJ; Mojica JE
  • Crit Care Explor 2020[Sep]; 2 (9): e0213 PMID32984835show ga
  • OBJECTIVES: To present three patients with severe coronavirus disease 2019 infection who developed life-threatening hyperpyrexia while being treated with dexmedetomidine for sedation. DATA SOURCES: Clinical records. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: We describe three patients, a 60-year-old female, 43-year-old female, and 46-year-old male, who were hospitalized in surge ICUs during the coronavirus disease 2019 pandemic in the early spring of 2020. All developed hyperpyrexia, defined as a temperature above 41.1 degrees C, following an increase in dexmedetomidine dosing to above 1.5 microg/kg/hr. Fevers resolved following discontinuation of dexmedetomidine. CONCLUSIONS: While the exact mechanism of hyperpyrexia remains unclear, findings in this study suggest that high doses of dexmedetomidine infusion are associated with hyperpyrexia in a seemingly dose-dependent fashion in critically ill patients with coronavirus disease 2019. Coronavirus disease 2019 infection causes a hyperinflammatory state characterized by pro-inflammatory cytokine dysregulation. Dexmedetomidine, a centrally acting alpha-2 agonist, may alter hypothalamic temperature regulation through disturbances in neurotransmitter expression and metabolism. We postulate that the use of high-dose dexmedetomidine in a hyperinflammatory state may increase the risk of developing hyperpyrexia in this severe disease state.
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