{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T07:01:11Z","timestamp":1780124471302,"version":"3.54.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100015613","name":"Centre Hospitalier Universitaire de Lille","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015613","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      Dexmedetomidine (DEX) is increasingly used for neonatal sedation, but safety data remain limited. We conducted a single-center retrospective study including neonates receiving continuous DEX infusion. Cardiorespiratory events were extracted from bedside monitoring during the 8\u00a0h before and the 24\u00a0h after initiation. Hemodynamic and clinical parameters were analyzed, and autonomic activity was assessed using Newborn Infant Parasympathetic Evaluation (NIPE) monitoring in a subgroup. Thirty-seven infants (18 preterm, 19 term) were included; 86% received concomitant morphine. Bradycardia episodes increased after DEX initiation, particularly in preterm infants (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In contrast, hypotension, lactate levels remained unchanged, while urine output varied over time without a clinically meaningful reduction. Hypoxemic events decreased, while oxygen requirements remained stable. In the NIPE subgroup, heart rate decreased, with a trend toward increased NIPE values. DEX was associated with increased bradycardia without clear evidence of impaired hemodynamic or respiratory tolerance. These findings suggest an overall reassuring short-term safety profile and suggest a physiologically mediated sedative effect.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td align=\"left\" colspan=\"2\">\n                                <jats:bold>What is Known:<\/jats:bold>\n                                \u2022\n                                <jats:italic>Dexmedetomidine is increasingly used for sedation\u00a0in preterm and term neonates, but cardiorespiratory safety data remain limited.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Bradycardia is the most frequently reported adverse effect.<\/jats:italic>\n                                <jats:bold>What is New:<\/jats:bold>\n                                \u2022\n                                <jats:italic>Continuous monitor-derived data show increased bradycardia after dexmedetomidine initiation, without hypotension or impaired\u00a0perfusion, while hypoxemic events decreased.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Autonomic monitoring (NIPE) suggests a trend toward increased parasympathetic activity, which may reflect modulation of autonomic balance under dexmedetomidine.<\/jats:italic>\n                              <\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00431-026-07000-7","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:12:23Z","timestamp":1777734743000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiorespiratory tolerance of continuous dexmedetomidine infusion in preterm and term newborn infants: a retrospective cohort study"],"prefix":"10.1007","volume":"185","author":[{"given":"Mathilde","family":"Blouin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sixtine","family":"Gilliot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Wojtanowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"De Jonckheere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Storme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Decaudin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Odou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Le Duc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Riadh","family":"Boukhris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"7000_CR1","doi-asserted-by":"publisher","first-page":"226","DOI":"10.4414\/smw.2009.12545","volume":"139","author":"E Cignacco","year":"2009","unstructured":"Cignacco E et al (2009) Neonatal procedural pain exposure and pain management in ventilated preterm infants during the first 14 days of life. Swiss Med Wkly 139:226\u2013232","journal-title":"Swiss Med Wkly"},{"key":"7000_CR2","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1038\/s41390-019-0744-6","volume":"88","author":"C McPherson","year":"2020","unstructured":"McPherson C, Miller SP, El-Dib M, Massaro AN, Inder TE (2020) The influence of pain, agitation, and their management on the immature brain. Pediatr Res 88:168\u2013175","journal-title":"Pediatr Res"},{"key":"7000_CR3","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.1016\/S0140-6736(04)16251-X","volume":"363","author":"KJS Anand","year":"2004","unstructured":"Anand KJS et al (2004) Effects of morphine analgesia in ventilated preterm neonates: primary outcomes from the NEOPAIN randomised trial. Lancet 363:1673\u20131682","journal-title":"Lancet"},{"key":"7000_CR4","first-page":"351","volume":"17","author":"C McPherson","year":"2012","unstructured":"McPherson C (2012) Sedation and analgesia in mechanically ventilated preterm neonates: continue standard of care or experiment? J Pediatr Pharmacol Ther 17:351\u2013364","journal-title":"J Pediatr Pharmacol Ther"},{"key":"7000_CR5","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1177\/1060028018812089","volume":"53","author":"DA Dersch-Mills","year":"2019","unstructured":"Dersch-Mills DA, Banasch HL, Yusuf K, Howlett A (2019) Dexmedetomidine use in a tertiary care NICU: a descriptive study. Ann Pharmacother 53:464\u2013470","journal-title":"Ann Pharmacother"},{"key":"7000_CR6","first-page":"227","volume":"24","author":"MN Sellas","year":"2019","unstructured":"Sellas MN, Kyllonen KC, Lepak MR, Rodriguez RJ (2019) Dexmedetomidine for the management of postoperative pain and sedation in newborns. J Pediatr Pharmacol Ther 24:227\u2013233","journal-title":"J Pediatr Pharmacol Ther"},{"key":"7000_CR7","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.ntt.2017.01.001","volume":"60","author":"A Alam","year":"2017","unstructured":"Alam A et al (2017) Neuroprotection and neurotoxicity in the developing brain: an update on the effects of dexmedetomidine and xenon. Neurotoxicol Teratol 60:102\u2013116","journal-title":"Neurotoxicol Teratol"},{"key":"7000_CR8","doi-asserted-by":"publisher","first-page":"31","DOI":"10.2344\/0003-3006-62.1.31","volume":"62","author":"JA Giovannitti","year":"2015","unstructured":"Giovannitti JA, Thoms SM, Crawford JJ (2015) Alpha-2 adrenergic receptor agonists: a review of current clinical applications. Anesth Prog 62:31\u201339","journal-title":"Anesth Prog"},{"key":"7000_CR9","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1007\/s10877-021-00670-8","volume":"35","author":"M Recher","year":"2021","unstructured":"Recher M et al (2021) The newborn infant parasympathetic evaluation in pediatric and neonatology: a literature review. J Clin Monit Comput 35:959\u2013966","journal-title":"J Clin Monit Comput"},{"key":"7000_CR10","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1007\/s00246-022-02854-8","volume":"43","author":"C McPherson","year":"2022","unstructured":"McPherson C, Liviskie CJ, Zeller B, Vesoulis ZA (2022) The impact of dexmedetomidine initiation on cardiovascular status and oxygenation in critically ill neonates. Pediatr Cardiol 43:1319\u20131326","journal-title":"Pediatr Cardiol"},{"key":"7000_CR11","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.jpeds.2013.10.002","volume":"164","author":"C Chrysostomou","year":"2014","unstructured":"Chrysostomou C et al (2014) A phase II\/III, multicenter, safety, efficacy, and pharmacokinetic study of dexmedetomidine in preterm and term neonates. J Pediatr 164:276-282.e1\u20133","journal-title":"J Pediatr"},{"key":"7000_CR12","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1038\/s41372-023-01802-5","volume":"44","author":"K Portelli","year":"2024","unstructured":"Portelli K, Kandraju H, Ryu M, Shah PS (2024) Efficacy and safety of dexmedetomidine for analgesia and sedation in neonates: a systematic review. J Perinatol 44:164\u2013172","journal-title":"J Perinatol"},{"key":"7000_CR13","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1007\/s10877-019-00276-1","volume":"33","author":"J De Jonckheere","year":"2019","unstructured":"De Jonckheere J, Storme L (2019) NIPE is related to parasympathetic activity. Is it also related to comfort? J Clin Monit Comput 33:747\u2013748","journal-title":"J Clin Monit Comput"},{"key":"7000_CR14","volume":"5","author":"JY Lim","year":"2024","unstructured":"Lim JY et al (2024) Dexmedetomidine for analgesia and sedation in newborn infants receiving mechanical ventilation. Cochrane Database Syst Rev 5:CD012361","journal-title":"Cochrane Database Syst Rev"},{"key":"7000_CR15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2022-001460","volume":"6","author":"S Ojha","year":"2022","unstructured":"Ojha S, Abramson J, Dorling J (2022) Sedation and analgesia from prolonged pain and stress during mechanical ventilation in preterm infants: is dexmedetomidine an alternative to current practice? BMJ Paediatr Open 6:e001460","journal-title":"BMJ Paediatr Open"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-07000-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-026-07000-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-07000-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:02:23Z","timestamp":1780120943000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-026-07000-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,2]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["7000"],"URL":"https:\/\/doi.org\/10.1007\/s00431-026-07000-7","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,2]]},"assertion":[{"value":"26 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective cohort study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The National Commission of Information and Liberty (CNIL) approved this study (number 067\/2022). Parents\u2019 non-opposition to the use of neonatal data for research was collected upon admission to the department of neonatology.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"337"}}