Clonidine for sedation in infants during therapeutic hypothermia with neonatal encephalopathy: pilot study

• DOI: 10.1038/s41372-021-01151-1
• Publication Date: 2021-09-16T15:03:32Z
• Authors: Estelle B. Gauda; Raul Chavez-Valdez; Frances J. Northi...; Carlton K. K. Lee; Michelle A. Rudek; Beatriz Guglieri-...; Vijay Ivaturi
• Keywords: Morphine; Infant, Newborn; Infant; Pilot Projects; Article; Clonidine; Infant, Newborn, Diseases; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Hypothermia, Induced; Hypoxia-Ischemia, Brain; Humans; Prospective Studies

To determine a safe dose of clonidine (CLON) to be used in infants with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).A pilot prospective study was performed to determine the effect of CLON on autonomic parameters, the pharmacokinetics (PK) of CLON, and the amount of morphine (MOR) given "as needed" for shivering and agitation in a cohort of infants (n = 12) with HIE undergoing TH compared to a historical control group (n = 28).The CLON group received less "as needed" MOR than the MOR-only group for agitation/shivering (p < 0.001), and the CLON vs. MOR-only group spent 92% vs. 79% of cooling time at the target core body temperature (CBT; p = 0.03, CLON vs. MOR).Intravenous CLON (1 mcg/kg Q8h) is well tolerated in infants treated with TH for HIE. CLON stabilizes CBT in the ideal range during cooling, which may be optimal for neuroprotection.