{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:55:44Z","timestamp":1777859744017,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Bradycardia is a known side effect of dexmedetomidine. Reports of sinus pauses or asystole, however, are rare. We present 2 cases of pediatric patients who developed asystole on a dexmedetomidine infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary of Cases:<\/jats:title>\n                    <jats:p>An 8-week-old male with RSV bronchiolitis and acute hypoxemic respiratory failure was started on dexmedetomidine for sedation at 0.2 mcg\/kg\/h with a maximum dose of 0.7mcg\/kg\/h. On Hospital day (HD) 4, on dexmedetomidine at 0.7 mcg\/kg\/h, he developed intermittent episodes of bradycardia with heart rates in the 60 s. Echocardiogram on HD 6 showed normal function. On HD 7, he began having periods of asystole lasting up to 6 seconds. Dexmedetomidine was discontinued, with the resolution of episodes of asystole after 6 hours. A 27-month-old male with a congenital left diaphragmatic hernia and pulmonary hypertension who had been weaned off sildenafil 6 months earlier underwent re-repair of left diaphragmatic hernia. Postoperatively he remained intubated and paralyzed. Dexmedetomidine was started at 0.3 mcg\/kg\/h for sedation, with a maximum dose of 1.2 mcg\/kg\/h. An echocardiogram on HD 3 showed good function with mild to moderate pulmonary hypertension. That evening, with dexmedetomidine at 1.1 mcg\/kg\/h, he developed a 15 second period of asystole requiring CPR. Dexmedetomidine was discontinued, and he was started on a midazolam infusion with no further episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Both cases occurred in patients without cardiac conduction defects or on negative chronotropic or sympatholytic medications that have been associated with dexmedetomidine-induced asystole. We hypothesize that both episodes of asystole were due to increased patient-related vagal tone exacerbated by dexmedetomidine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08971900211027133","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T05:10:34Z","timestamp":1624511434000},"page":"176-179","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Asystole in 2 Pediatric Patients During Dexmedetomidine Infusion"],"prefix":"10.1177","volume":"36","author":[{"given":"Katrin","family":"Lichtsinn","sequence":"first","affiliation":[{"name":"Pediatrics, University of Texas at Austin Dell Medical School Program, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ila","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Pediatrics, University of Texas at Austin Dell Medical School Program, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3044-529X","authenticated-orcid":false,"given":"Alexandra","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, Dell Medical School, University of Texas at Austin Dell Children\u2019s Ascension, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"bibr1-08971900211027133","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.02.176"},{"key":"bibr2-08971900211027133","doi-asserted-by":"publisher","DOI":"10.4097\/kja.19259"},{"key":"bibr3-08971900211027133","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181adc506"},{"key":"bibr4-08971900211027133","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2015.06.012"},{"key":"bibr5-08971900211027133","unstructured":"Precedex (dexmedetomidine hydrochloride injection) [package insert]. 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