TABLE 2.
Withdrawal Symptoms, Sedatives Administered, and Patient Length of Stay
| Variables | Patients Administered Clonidine Taper (n = 15) | Patients Weaned Off Dexmedetomidine Alone (n = 27) | p |
|---|---|---|---|
| Incidence of ≥ 2 withdrawal symptoms, n (%) | 11 (73) | 16 (59) | 0.51 |
| Individual withdrawal symptoms, n (%) | |||
| Heart rate > 90 beats/min | 12 (80) | 20 (74) | 1 |
| Confusion Assessment Method for the ICU + | 11 (73) | 17 (63) | 0.73 |
| Systolic blood pressure > 140 mm Hg | 6 (40) | 8 (30) | 0.55 |
| RASS > +1 | 6 (40) | 3 (11) | 0.05 |
| WAT-1 > 2 | 2 (13) | 1 (4) | 0.29 |
| Individual WAT-1 components, n (%) | |||
| Pre stimulus | |||
| RASS > 0 | 6 (40) | 4 (15) | 0.13 |
| Loose/watery stools | 3 (20) | 13 (48) | 0.1 |
| Temperature > 37.8°C | 3 (20) | 8 (29) | 0.72 |
| Vomiting | 1 (7) | 2 (7) | 1 |
| Diaphoresis | 1 (7) | 3 (11) | 1 |
| Moderate-severe repetitive movements | 0 | 1 (4) | 1 |
| Moderate-severe tremor | 0 | 0 | |
| Yawning or sneezing | 0 | 0 | |
| Post stimulus | |||
| Moderate-severe startle to touch | 0 | 0 | |
| Increased muscle tone | 0 | 0 | |
| 2+ min to return to calm state | 0 | 0 | |
| 5+ min to return to calm state | 0 | 0 | |
| Number of assessments conducted per patient, mean ± sd | 3.7 ± 1.2 | 2.7 ± 0.8 | <0.01 |
| Incidence of pain during the wean period, n (%) | 7 (47) | 11 (41) | 0.75 |
| Propofol used during the wean period, n (%) | 5 (33) | 8 (30) | 1 |
| Antipsychotics used during the wean period, n (%) | 9 (60) | 10 (37) | 0.2 |
| Benzodiazepines used during the wean period, n (%) | 3 (20) | 3 (11) | 0.34 |
| Ketamine used during the wean period, n (%) | 1 (7) | 4 (15) | 0.64 |
| Average daily dexmedetomidine ratea (µg/hr), mean ± sd | 75 ± 28.1 | 66.5 ± 30 | 0.37 |
| Average daily dexmedetomidine ratea (µg/kg/hr), mean ± sd | 0.9 ± 0.3 | 0.7 ± 0.3 | 0.03 |
| Time on dexmedetomidine after wean initiation (hr), median (IQR) | 19 (9.5–23) | 43 (14–74.7) | 0.02 |
| ICU length of stay (d), median (IQR) | 22.7 (16.3–35) | 17 (10.7–33.5) | 0.3 |
| Time to ICU discharge after dexmedetomidine wean initiation (d), median (IQR) | 7.2 (4–20) | 7 (3.1–20) | 0.69 |
IQR = interquartile range, RASS = Richmond Agitation-Sedation Scale, WAT-1 = Withdrawal Assessment Tool 1.
aAverage daily dexmedetomidine rate was calculated based on the infusion rate throughout the total infusion duration (not limited to the wean period).