Retrospective study of dexmedetomidine continuous infusion as bridge sedation for severely agitated adolescents (ages 12–17) in the ED over a 16-month period, with primary outcome of need for additional sedation during infusion.
In 20 patients (median age 15 years), median infusion duration was 21 hours at a median max dose of 1.6 mcg/kg/hr; 45% (9/20, 95% CI 26–66%) required additional sedation, 5 were transferred to the PICU, and 1 experienced a desaturation event that resolved with head repositioning and supplemental oxygen.
Very small sample (n=20), single-center retrospective design, and no control group limit generalizability and causal inference.
Dexmedetomidine infusion may offer a feasible bridge sedation option for severely agitated adolescents in the ED awaiting psychiatric care, but nearly half still required additional sedatives and 25% needed PICU transfer — close monitoring is essential.
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