Mateos Gaitán, RobertoVicent, LourdesRodríguez Queraltó, OriolLópez de Sa, EstebanElorriaga, AnePastor, GemmaBañeras, JordiLorenzo López, BeatrizGarcía Rubira, Juan CarlosMartínez Sellés Oliveria Soares, ManuelEt al.2020-06-172020-06-172020Mateos Gaitán, R., Vicent, L., Rodríguez-Queralto, O., López-de-Sa, E., Elorriaga, A., Pastor, G., Bañeras, J., Lorenzo, B., García-Rubira, J. C., Corbí, M., Ariza, A., & Martínez-Sellés, M. (2020). Dexmedetomidine in medical cardiac intensive care units. Data from a multicenter prospective registry. International Journal of Cardiology, 310, 162–166. https://doi.org/10.1016/j.ijcard.2020.04.0020167-52731874-1754http://hdl.handle.net/11268/8958Background: Dexmedetomidine induces cooperative and arousable sedation. Our aim was to analyze dexmedetomidine use in medical cardiac intensive care units (CICU). Methods: Multicenter prospective registry of patients treated with dexmedetomidine in CICU. Consecutive inclusion during a 12-month period. Results: A total of 410 patients were included, mean age was 67.4 ± 13.9 years, and 94 (22.9%) were women. Before using dexmedetomidine, 247 patients (60.2%) had delirium, 48 developed delirium after dexmedetomidine use. In 178 (43.4%) dexmedetomidine was used during weaning from mechanical ventilation, with a reintubation rate of 10.1%, early reintubation rate (<24 h) 1.7%. Seventy-seven patients (18.8%) died during admission. Dexmedetomidine mean dose infusion was 0.51 ± 0.25 μ/kg/h, during a median of 34 h (interquartile range 12-78 h). Three hundred forty-eight patients received adjuvant sedatives (84.9%). Sixty-eight patients (16.6%) had adverse effects. The most frequent adverse effects were hypotension with systolic blood pressure <80 mmHg (44 patients - 10.7%), bradycardia <40 beats per minute (15 patients - 3.7%), and both bradycardia and hypotension (4 patients - 1.0%). Patients with adverse effects received more frequently inotropes (53 [81.6%] vs. 212 [65.4%], p = 0.02) and fewer adjuvant sedatives (49 [75.4%] vs. 282 [87.0%], p = 0.01). The independent predictors of adverse effects were inotropes use (odds ratio [OR] 2.73, 95% confidence interval [CI] 1.30-5.74, p = 0.008) and lack of adjuvant sedatives (OR 3.03, 95% CI 1.49-6.26, p = 0.002). Conclusion: Dexmedetomidine safety for medical CICU patients seems to be similar to that for general intensive care unit patients. Inotropes and lack of adjuvant sedatives were associated with adverse effects.engjournal article10.1016/j.ijcard.2020.04.002restricted accessMedicamentos cardiovascularesUnidades de cuidados intensivosEnfermedad cardiovascularMedicamentoHospital