{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:11:08Z","timestamp":1777421468027,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"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":["Ann Pharmacother"],"published-print":{"date-parts":[[2023,2]]},"abstract":"\n Background<\/jats:title>\n Dexmedetomidine is commonly used to achieve light sedation in patients on extracorporeal membrane oxygenation (ECMO) despite minimal evidence. In vivo studies have shown dexmedetomidine sequestration in ECMO circuits, and higher doses may be used to overcome sequestration.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The purpose of this study was to compare safety and efficacy of dexmedetomidine at standard versus high doses in ECMO<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective analysis of adult ECMO patients was performed. Patients were compared as receiving either standard-dose (\u22641.5 \u00b5g\/kg\/h) or high-dose (>1.5 \u00b5g\/kg\/h) dexmedetomidine. Safety outcomes included new onset bradycardia or hypotension. Efficacy was compared by the addition of concomitant sedative and analgesic agents.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n One hundred five patients were evaluated, with 20% of patients in the high-dose group. Comparing standard and high dosing, no significant differences were seen in primary safety outcomes including bradycardia (49% vs 38%,\n P<\/jats:italic>\n = 0.46), hypotension (79% vs 71%,\n P<\/jats:italic>\n = 0.56), or addition of vasopressors (75% vs 71%,\n P<\/jats:italic>\n = 0.78). Need for concomitant analgesic agents and propofol was similar between groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion and Relevance<\/jats:title>\n This represents the first evaluation of use of high-dose dexmedetomidine in ECMO. Rates of dexmedetomidine higher than 1.5 \u00b5g\/kg\/h were commonly used in patients on ECMO, with similar rates of adverse effects and need for concomitant propofol and analgesic agents. While high-dose dexmedetomidine may be as safe as standard dose, no additional efficacy was found.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10600280221102474","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T09:44:10Z","timestamp":1654767850000},"page":"121-126","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of Standard-Dose Versus High-Dose Dexmedetomidine in Extracorporeal Membrane Oxygenation"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0345-3403","authenticated-orcid":false,"given":"Erika L.","family":"Zarfoss","sequence":"first","affiliation":[{"name":"Department of Pharmacy, WVU Medicine \u2013 West Virginia University Hospitals, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Garavaglia","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, WVU Medicine \u2013 West Virginia University Hospitals, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. W. Awori","family":"Hayanga","sequence":"additional","affiliation":[{"name":"Department of Medicine, WVU Medicine \u2013 West Virginia University Hospitals, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7510-9447","authenticated-orcid":false,"given":"Galen","family":"Kabulski","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, WVU Medicine \u2013 West Virginia University Hospitals, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028019877806."},{"key":"e_1_3_2_3_2","volume-title":"ELSO Guidelines for Cardiopulmonary Extracorporeal Life Support. Version 1.4","author":"Extracorporeal Life Support Organization","year":"2017","unstructured":"Extracorporeal Life Support Organization. ELSO Guidelines for Cardiopulmonary Extracorporeal Life Support. Version 1.4. Ann Arbor, MI: Extracorporeal Life Support Organization; 2017."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002702."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.05.014."},{"key":"e_1_3_2_6_2","unstructured":"Dexmedetomidine (Precedex) [package insert]. Lake Forest IL: Hospira; 2013."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2015.06.012."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.304."},{"key":"e_1_3_2_9_2","unstructured":"\u201cDexmedetomidine\u201d Drugbank Online. Accessed July 27 2021. https:\/\/go.drugbank.com\/drugs\/DB00633."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.21767\/2471-8505.100025."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1882."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659112456894."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659119868062."},{"issue":"2","key":"e_1_3_2_14_2","first-page":"81","article-title":"PPM launches online opioid calculator","volume":"12","author":"Brennan M","year":"2012","unstructured":"Brennan M, Fudin J, Perkins R. PPM launches online opioid calculator. 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