{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:47:42Z","timestamp":1783734462663,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002345"],"award-info":[{"award-number":["UL1TR002345"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dexmedetomidine (DEX) is a centrally acting sympatholytic sedative. Abundant evidence from the intensive care unit and other settings demonstrates that the use of DEX is associated with improved sedation\u2010related outcomes. There is a paucity of data on the use and efficacy of DEX in the emergency department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a prospective single\u2010center observational cohort study of patients treated with intravenous DEX for any indication in the ED. We performed serial bedside evaluations of sedation depth and delirium and administered standardized questionnaires to ED physicians about their use of DEX. We assessed the incidence of hemodynamic adverse events (HAEs; bradycardia or hypotension), clinically significant HAEs (HAEs accompanied by clinical intervention or discontinuation of DEX), sedation\u2010related ED outcomes, and clinician perception of DEX effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 75 patients treated with DEX in the ED during our study period. The most common indication for DEX was noninvasive positive pressure ventilation (32 patients, 43%). DEX was administered in the ED for a median of 2.6\u2009h (interquartile range [IQR] 1.6\u20134.9 h), with a median infusion rate of 0.3\u2009\u03bcg\/kg\/h (IQR 0.2\u20130.4\u2009\u03bcg\/kg\/h). Clinically significant HAE occurred in nine patients (12%, 95% CI 6%\u201322%). Other sedative or analgesic infusions were administered in the ED to 21 patients (28%). Clinicians felt DEX was highly effective (median [IQR] effectiveness score of 5 [3\u20135] on a 5\u2010point Likert scale). The median (IQR) ED Richmond Agitation Sedation Scale post\u2010DEX was \u22121 (\u22124 to 0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DEX is used in the ED for diverse indications. Additional data from larger cohorts and comparative studies are required to determine the precise incidence of clinically significant HAE associated with DEX use in the ED. ED clinicians have a positive perception of the effectiveness of DEX.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14842","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T05:08:20Z","timestamp":1702012100000},"page":"263-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dexmedetomidine in the emergency department: A prospective observational cohort study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0875-423X","authenticated-orcid":false,"given":"Kevin","family":"Baumgartner","sequence":"first","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency Medicine Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Joseph","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Lothet","sequence":"additional","affiliation":[{"name":"Emergency Medicine Residency Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3757-756X","authenticated-orcid":false,"given":"Brian M.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Anesthesiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-017-0507-7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.4.5.619"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2165\/11207190-000000000-00000"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.56"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.22.2644"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.304"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.12.052"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0169525"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2022.2138761"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxac378"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14636"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2021.4.50917"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2107138"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2703"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.05.003"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.03.013"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0000000000000022"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2011-200849"},{"issue":"1","key":"e_1_2_10_23_1","first-page":"S381","article-title":"809: the use of dexmedetomidine for agitation and procedural sedation the emergency department [abstract]","volume":"28","author":"Krenz J","year":"2021","journal-title":"Acad Emerg Med"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003928"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.05.041"}],"container-title":["Academic Emergency 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