• Jamal Salah, Philip Grgurich, Katharine Nault, and Yuxiu Lei.
• Lahey Hospital & Medical Center, 41 Burlington Mall Road, Burlington, MA 01803, United States of America. Electronic address: j4m4ls@gmail.com.
• J Crit Care. 2020 Oct 1; 59: 81-85.

PurposeDexmedetomidine may cause hypertension and tachycardia upon discontinuation. Risk factors are poorly described but may include prolonged infusion, higher doses, a history of hypertension, and abrupt cessation. This study aims to identify risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation.Materials/MethodsIn this single-center, case-control study, critically ill patients requiring dexmedetomidine for 6 h or more were screened for hypertension or tachycardia within 24 h of discontinuation. We compared baseline and dexmedetomidine-specific data between patients who developed hypertension or tachycardia (cases) and those who did not (controls) and used logistic regression to identify independent risk factors.ResultsOf 110 patients, 35 (31.8%) experienced hypertension or tachycardia. When comparing cases to controls, the maximum dexmedetomidine dose was 0.7 and 0.75 μg/kg/h (p = .54), cumulative dose was 1174.5 and 1063.5 μg/kg/h (p = .43), and duration was 31and 23.25 h (p = .22), respectively. Only a past medical history of hypertension was an independent predictor of hypertension or tachycardia upon dexmedetomidine discontinuation.ConclusionsApproximately one third of patients experienced hypertension or tachycardia upon dexmedetomidine discontinuation. A past medical history of hypertension was the only independent risk factor identified in this study based on the clinical data collected.Copyright © 2020 Elsevier Inc. All rights reserved.

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