Ann Emerg Med. 2026 Aug 31:S0196-0644(26)00469-5. doi: 10.1016/j.annemergmed.2026.07.004. Online ahead of print.
ABSTRACT
STUDY OBJECTIVES: Adolescents with severe agitation may require repeated administration of sedatives. We describe dexmedetomidine infusion as a novel bridge therapy for selected agitated adolescents awaiting psychiatric treatment and disposition.
METHODS: We retrospectively studied adolescents (12 to 17 years) treated with dexmedetomidine infusion for severe agitation at our emergency department (ED) over a 16-month period. We abstracted demographics, sedatives administered, psychiatric therapy, type and frequency of adverse events, and ED disposition. Our primary outcome was the need for additional sedation despite dexmedetomidine.
RESULTS: The median age of our 20 qualifying patients was 15 years. The median duration of dexmedetomidine infusion was 21 hours, with a median maximum dose of 1.6 mcg/kg per hour. During the infusion, 9 patients (45%, 95% confidence interval 26% to 66%) required additional sedation. One patient experienced desaturation responding to head repositioning and supplemental oxygen. Five patients were transferred to the pediatric ICU owing to the need of multiple sedatives.
CONCLUSION: Our preliminary results support the feasibility of dexmedetomidine infusion as bridge sedation for selected severely agitated adolescents awaiting psychiatric care and disposition.
PMID:42678315 | DOI:10.1016/j.annemergmed.2026.07.004
