Dexmedetomidine is an excellent agent for sedation status-post lung transplant

"Zhang and colleagues describe, in this issue of Journal of Clinical Anesthesia , a 10-second episode of asystole in an adolescent with cystic fibrosis (CF) following double-lung transplant, whose lungs were being mechanically ventilated while receiving a dexmedetomidine infusion for sedation. Dexmedetomidine is a novel alpha-2A adenergic receptor agonist used as a sedative in the intensive care unit and the operating room. It has sedative, analgesic, and sympatholytic properties associated with minimal respiratory depression. Dexmedetomidine is FDA-approved at a dose of one mcg/kg administered over ten plus minutes followed by an infusion of 0.2-0.7 mcg/kg/hr for sedation of mechanically ventilated patients. Because it is sedating without either amnestic or respiratory depressive effects, it is ideal for weaning patients with pulmonary disease and/or patients requiring serial neurological examination."