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Dexmedetomidine, an alpha\u20102 agonist, might be interesting to spare opioid and benzodiazepine use. The objective of this study was to describe a cohort of mechanically ventilated extremely, preterm infants treated with morphine with or without dexmedetomidine. This was a retrospective, observational, single\u2010center study in the neonatal intensive care unit of Creteil. We included preterm neonates born before 28\u2009weeks of gestation and\/or weighting less than 1000\u2009g hospitalized between July 2017 and June 2020, on mechanical ventilation for at least 72\u2009h and who received morphine with or without dexmedetomidine as a second\u2010 or third\u2010line treatment. We described morphine and midazolam exposure, respiratory, and digestive outcomes for patients who received dexmedetomidine and those who did not. Twenty nine preterm infants received morphine and dexmedetomidine, and 44 received morphine without dexmedetomidine. Dexmedetomidine was used in patients of 25.7 [25.1\u201326.7] weeks, 680 [600\u2013750] g and significantly more often in patients with vascular complications during pregnancy (<jats:italic>p<\/jats:italic>\u2009=\u20090.008), intrauterine growth restriction (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) and in patients who received higher cumulative doses of morphine (<jats:italic>p<\/jats:italic>\u2009=\u20090.01). Morphine and midazolam doses tended to decrease after the introduction of dexmedetomidine. Dexmedetomidine was never discontinued because of side effects. In this study, dexmedetomidine, used as a second or third\u2010line treatment during mechanical ventilation, was associated with a decrease in morphine and midazolam doses after introduction. Dexmedetomidine was used in a specific population of extremely preterm infants, with severe respiratory disease, who required prolonged mechanical ventilation and high morphine doses. This study highlights the need for pharmacokinetic\/pharmacodynamic studies in this population, followed by randomized controlled trials and studies on the long\u2010term effects of dexmedetomidine to determine its place in analgosedation of ventilated preterm infants.<\/jats:p>","DOI":"10.1002\/pne2.12130","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T15:57:33Z","timestamp":1721404653000},"page":"194-202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of dexmedetomidine during mechanical ventilation in extremely preterm and extremely low birth weight neonates receiving morphine: A single\u2010center retrospective study"],"prefix":"10.1002","volume":"6","author":[{"given":"Camille","family":"Irving","sequence":"first","affiliation":[{"name":"R\u00e9animation n\u00e9onatale Centre Hospitalier Intercommunal de Cr\u00e9teil  Cr\u00e9teil 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