Clonidine dosing after acute pediatric brain injury
Presenter Status
Fellow
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
Kim Hartman
Presentation Type
Poster
Start Date
20-5-2026 11:00 AM
End Date
20-5-2026 12:00 PM
Abstract Text
Background: While numerous evidence-based neuropharmacologic treatments exist for managing acquired brain injury in adults, there is a lack of data on the use of medication in pediatric patients. One such medication is Clonidine, an alpha-2 agonist that acts centrally to decrease sympathetic outflow, brain edema, and agitation. There is limited literature on the indications and optimal dosing of Clonidine in pediatric brain injury.
Objectives/Goal: This study aims to explore the frequency of Clonidine use in pediatric patients with acute brain injury and to clarify the starting, therapeutic (maximum), and discharge doses.
Methods/Design: Retrospective chart review at a single pediatric tertiary acute care hospital. Participants included patients ages 0-18 years admitted to a children’s hospital from January 2024 through December 2024 with a diagnosis of acute brain injury and who had pediatric rehabilitation consultation (N=127). The main outcome measures were: 1) frequency of Clonidine use in pediatric patients with acute brain injury, and 2) starting, therapeutic (maximum), and discharge doses of Clonidine.
Results: Of the 127 patients with acute brain injury, 38 (29.9%) were started on Clonidine during their inpatient hospitalization. The median starting dose was 4.87 mcg/kg/day (interquartile range (IQR) 2.66-7.07 mcg/kg/day). The median therapeutic (maximum) dose was around 160% of the starting dose at 7.85 mcg/kg/day (IQR 4.82-10.19 mcg/kg/day). Three patients who were started on Clonidine succumbed to their injuries. Of the 35 patients who survived, 17 (48.6%) continued Clonidine at discharge at a median dose 6.26 mcg/kg/day (IQR 2.19-8.22 mcg/kg/day), nearly 80% of the therapeutic (maximum) dose.
Conclusions: Clonidine was started in nearly one-third of pediatric patients with acute brain injury. While patients frequently required up-titration to achieve therapeutic dosing, over half were able to wean off the medication completely before discharge.
Clonidine dosing after acute pediatric brain injury
Background: While numerous evidence-based neuropharmacologic treatments exist for managing acquired brain injury in adults, there is a lack of data on the use of medication in pediatric patients. One such medication is Clonidine, an alpha-2 agonist that acts centrally to decrease sympathetic outflow, brain edema, and agitation. There is limited literature on the indications and optimal dosing of Clonidine in pediatric brain injury.
Objectives/Goal: This study aims to explore the frequency of Clonidine use in pediatric patients with acute brain injury and to clarify the starting, therapeutic (maximum), and discharge doses.
Methods/Design: Retrospective chart review at a single pediatric tertiary acute care hospital. Participants included patients ages 0-18 years admitted to a children’s hospital from January 2024 through December 2024 with a diagnosis of acute brain injury and who had pediatric rehabilitation consultation (N=127). The main outcome measures were: 1) frequency of Clonidine use in pediatric patients with acute brain injury, and 2) starting, therapeutic (maximum), and discharge doses of Clonidine.
Results: Of the 127 patients with acute brain injury, 38 (29.9%) were started on Clonidine during their inpatient hospitalization. The median starting dose was 4.87 mcg/kg/day (interquartile range (IQR) 2.66-7.07 mcg/kg/day). The median therapeutic (maximum) dose was around 160% of the starting dose at 7.85 mcg/kg/day (IQR 4.82-10.19 mcg/kg/day). Three patients who were started on Clonidine succumbed to their injuries. Of the 35 patients who survived, 17 (48.6%) continued Clonidine at discharge at a median dose 6.26 mcg/kg/day (IQR 2.19-8.22 mcg/kg/day), nearly 80% of the therapeutic (maximum) dose.
Conclusions: Clonidine was started in nearly one-third of pediatric patients with acute brain injury. While patients frequently required up-titration to achieve therapeutic dosing, over half were able to wean off the medication completely before discharge.
Comments
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Poster Board Number: 17