AIM: RESULTS: A total of 3427 studies were screened for inclusion with three meeting inclusion criteria with a total of 88 patients. All three studies were observational, two being prospective and one retrospective. In all included studies, the choice to start enteral
clonidine to wean off
dexmedetomidine was made at the discretion of the physician. Weaning time ranged from 13 to 167 h on average. Enteral
clonidine was started in the prospective studies in a similar protocolized method, with 0.3 mg every 6 h. After starting
clonidine, patients remained on
dexmedetomidine for a median of 1-28 h. Following the termination of
dexmedetomidine, two trials tapered enteral
clonidine by increasing the interval every 24 h from 6 h to 8h, 12h, and 24 h, followed by
clonidine discontinuation. For indicators of enteral
clonidine withdrawal, the previously tolerable dosage was reinstated for several days before resuming the taper on the same protocol. The adverse events associated with enteral
clonidine use were higher than patients on
dexmedetomidine taper alone with increased agitation. The re-initiation of
dexmedetomidine was not documented in any study. Only 17 (37%) patients were mechanically ventilated with median duration of 3.5 d for 13 patients in one of the 2 studies. ICU lengths of stay were similar.
CONCLUSION: