Browsing by Author "Unland, Tamara"

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    Corrigendum to "High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI"
    (Hindawi, 2015-06-02) Ahmed, Sheikh Sohail; Unland, Tamara; Slaven, James E.; Nitu, Mara E.; Pediatrics, School of Medicine
    A previous study conducted at the same institution, with a patient population of 77, concluded that high dose dexmedetomidine can be successfully used for MRI sedation in children, with 29% of patients requiring additional agents for optimal sedation [19]. In our study, over the course of five years, the patient cohort was larger (544 patients) and included the previously reported 77-patient cohort. This larger patient cohort analysis validated previously reported data: 100% success of the existing sedation protocol, rounded up from 99.8% acknowledging one patient failure, with the adjunctive sedative agents used on 21.5% of cases.
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    High dose dexmedetomidine: effective as a sole agent sedation for children undergoing MRI
    (Hindawi, 2015-01-29) Sohail Ahmed, Sheikh; Unland, Tamara; Slaven, James E.; Nitu, Mara E.; Pediatrics, School of Medicine
    OBJECTIVE: To determine the efficacy and safety of high dose dexmedetomidine as a sole sedative agent for MRI. We report our institution's experience. DESIGN: A retrospective institutional review of dexmedetomidine usage for pediatric MRI over 5.5 years. Protocol included a dexmedetomidine bolus of 2 μg/kg intravenously over ten minutes followed by 1 μg/kg/hr infusion. 544 patients received high dose dexmedetomidine for MRI. A second bolus was used in 103 (18.9%) patients. 117 (21.5%) required additional medications. Efficacy, side effects, and use of additional medicines to complete the MRI were reviewed. Data was analyzed using Student's t-test, Fisher's exact test, and Analysis of Variance (ANOVA). MAIN RESULTS: Dexmedetomidine infusion was associated with bradycardia (3.9%) and hypotension (18.4%). None of the patients required any intervention. Vital signs were not significantly different among the subgroup of patients receiving one or two boluses of dexmedetomidine or additional medications. Procedure time was significantly shorter in the group receiving only one dexmedetomidine bolus and increased with second bolus or additional medications (P < 0.0001). Discharge time was longer for children experiencing bradycardia (P = 0.0012). CONCLUSION: High dose Dexmedetomidine was effective in 78.5% of cases; 21.5% of patients required additional medications. Side effects occurred in approximately 25% of cases, resolving spontaneously.