P0042 / #525: COMPARISION OF ALPHA-2AGONISTS FOR SEDATION IN CHILDREN RECEIVING NONINVASIVE VENTILATION: A RETROSPECTIVE COHORT STUDY

Abstract

Aims & Objectives: Clonidine (Clo) and dexmedetomidine (Dex) are usually drugs used for sedation during non-invasive ventilation (NIV). We compared the safety of sedation with Dex vs. Clo in children receiving NIV Methods: Design: Retrospective cohort study with propensity-matched analysis between June 2018 and June 2019. Setting and participants: Pediatric intensive care unit (PICU) within a tertiary care children´s hospital. Patients from 1 month to 15 years with respiratory failure, who received NIV and infusion of Clo or Dex, according to physician decision to achieve sedation [State Behavior Scale (SBS) -1-0], within 48 hours of admission. Cardiorespiratory parameters, SBS and adverse events were recorded. Main outcome measure: incidence of adverse events (hypotension and bradycardia) Results: Of 139 patients, propensity match identified 47 pairings of patients who received Clo or Dex. After matching there was no difference in the participants among both groups. One hypotension event was observed in the Dex group (2.1%) and none in the Clo group (p = 0.999).The incidence of bradycardia was different between both groups [Dex vs Clo; 19 (40.4%) vs. 6 (12.8%); RAR 0.274 (95% CI 0.111 to 0.425); p = 0.02]. The use of Dex was an independent factor for the development of bradycardia, both in the total sample [adjusted OR 3.34 (95% CI 1.47-7.78); p = 0.004] as well as in the paired sample [OR adjusted 3.81 (95% CI 1.31-11.0); p = 0.014]. Conclusions: Both drugs achieved an adequate level of sedation during NIV. The Clo group was associated with lesser bradycardia.