Transition from Dexmedetomidine to Enteral Clonidine for ICU Sedation: An Observational Pilot Study
This was a single-center, prospective, observational study conducted to test the hypothesis that transitioning adult ICU patients from dexmedetomidine to enteral clonidine is safe, effective, and less costly. A total of 20 patients were evaluated with a median age of 62 years of age. In this study, the transition from dexmedetomidine to enteral clonidine was as follows:
Efficacy: Ten (50%) patients were successfully transitioned from dexmedetomidine within 24 hours of their first clonidine dose and 15 (75%) transitioned with 48 hours.
Safety: No statistically significant differences in safety data
Both of the mentioned studies above had few patients included in their analysis with only one study describing a dosing strategy for initiating and tapering off clonidine. Based on the data from these 2 studies, it is not completely clear on what exact dose of clonidine to initiate in a patient. Many factors have to be considered including diagnosis, age, body weight, hepatic function, potential drug interactions, and sedation goal.
Based on these 2 studies, it is reasonable to consider the following dosing strategy:
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