Safety and efficacy of chloral hydrate sedation in children undergoing echocardiography
The purpose of this prospective study was to determine the safety and efficacy of chloral hydrate sedation in children with known or suspected congenital heart disease. The study population included 405 children with a median age of 13 months (3 weeks to 14 years). Cyanotic heart disease was present...
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Published in | The Journal of pediatrics Vol. 129; no. 2; pp. 287 - 291 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
United States
Mosby, Inc
01.08.1996
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Abstract | The purpose of this prospective study was to determine the safety and efficacy of chloral hydrate sedation in children with known or suspected congenital heart disease. The study population included 405 children with a median age of 13 months (3 weeks to 14 years). Cyanotic heart disease was present in 64 of the children. The median dosage of chloral hydrate given was 77 mg/kg, with a range of 25 to 125 mg/kg. Sedation was achieved in 397 (98%) of the children. The complete study time averaged 2.2 hours (range, 1.6 to 5.2 hours). The time to achieve sedation was 30 minutes or less in 82%, more than 30 but less than 60 minutes in 12%, and more than 60 minutes in 4%; 2% failed to achieve sedation. Children aged 3 years or younger were more likely to be successfully sedated with chloral hydrate (
p = 0.003). The type of heart disease did not affect the success of sedation. No child had a clinically significant change in heart rate or blood pressure during sedation; however, oxygen saturation decreased in 24 (6%) of 397 children successfully sedated. Decreases in oxygen saturation occurred more commonly in children with trisomy 21 (7/13) than in children without genetic syndromes (17/384). Vomiting occurred in 23 (6%) of the 405 study subjects, usually immediately after drug administration. Chloral hydrate is a safe and effective agent for sedation of children with known or suspected congenital heart disease who are undergoing echocardiography in the outpatient cardiology clinic. (J P
EDIATR 1996;129:287-91) |
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AbstractList | The purpose of this prospective study was to determine the safety and efficacy of chloral hydrate sedation in children with known or suspected congenital heart disease. The study population included 405 children with a median age of 13 months (3 weeks to 14 years). Cyanotic heart disease was present in 64 of the children. The median dosage of chloral hydrate given was 77 mg/kg, with a range of 25 to 125 mg/kg. Sedation was achieved in 397 (98%) of the children. The complete study time averaged 2.2 hours (range, 1.6 to 5.2 hours). The time to achieve sedation was 30 minutes or less in 82%, more than 30 but less than 60 minutes in 12%, and more than 60 minutes in 4%; 2% failed to achieve sedation. Children aged 3 years or younger were more likely to be successfully sedated with chloral hydrate (p = 0.003). The type of heart disease did not affect the success of sedation. No child had a clinically significant change in heart rate or blood pressure during sedation; however, oxygen saturation decreased in 24 (6%) of 397 children successfully sedated. Decreases in oxygen saturation occurred more commonly in children with trisomy 21 (7/13) than in children without genetic syndromes (17/384). Vomiting occurred in 23 (6%) of the 405 study subjects, usually immediately after drug administration. Chloral hydrate is a safe and effective agent for sedation of children with known or suspected congenital heart disease who are undergoing echocardiography in the outpatient cardiology clinic. The purpose of this prospective study was to determine the safety and efficacy of chloral hydrate sedation in children with known or suspected congenital heart disease. The study population included 405 children with a median age of 13 months (3 weeks to 14 years). Cyanotic heart disease was present in 64 of the children. The median dosage of chloral hydrate given was 77 mg/kg, with a range of 25 to 125 mg/kg. Sedation was achieved in 397 (98%) of the children. The complete study time averaged 2.2 hours (range, 1.6 to 5.2 hours). The time to achieve sedation was 30 minutes or less in 82%, more than 30 but less than 60 minutes in 12%, and more than 60 minutes in 4%; 2% failed to achieve sedation. Children aged 3 years or younger were more likely to be successfully sedated with chloral hydrate ( p = 0.003). The type of heart disease did not affect the success of sedation. No child had a clinically significant change in heart rate or blood pressure during sedation; however, oxygen saturation decreased in 24 (6%) of 397 children successfully sedated. Decreases in oxygen saturation occurred more commonly in children with trisomy 21 (7/13) than in children without genetic syndromes (17/384). Vomiting occurred in 23 (6%) of the 405 study subjects, usually immediately after drug administration. Chloral hydrate is a safe and effective agent for sedation of children with known or suspected congenital heart disease who are undergoing echocardiography in the outpatient cardiology clinic. (J P EDIATR 1996;129:287-91) |
Author | Napoli, Kathy Little Ingall, Carrie Goren Martin, Gerard R. |
Author_xml | – sequence: 1 givenname: Kathy Little surname: Napoli fullname: Napoli, Kathy Little – sequence: 2 givenname: Carrie Goren surname: Ingall fullname: Ingall, Carrie Goren – sequence: 3 givenname: Gerard R. surname: Martin fullname: Martin, Gerard R. |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/8765629$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1097/00007611-199009000-00015 10.1016/0002-8703(91)90981-M 10.1016/0002-9149(78)90635-5 10.3928/0191-3913-19900901-06 10.1213/00000539-198606000-00023 10.1148/radiology.143.2.7071350 10.1136/bmj.2.6093.994 |
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References_xml | – volume: 42 start-page: 641 year: 1978 end-page: 647 ident: bib2 article-title: Congenital heart disease in a cohort of 19,502 births with long-term follow-up publication-title: Am J Cardiol contributor: fullname: Christianson – year: 1990 ident: bib6 publication-title: American Hospital Formulary Service, '90 – volume: 83 start-page: 1040 year: 1990 end-page: 1043 ident: bib10 article-title: Efficacy of sedation of children with chloral hydrate publication-title: South Med J contributor: fullname: Atkinson – volume: 143 start-page: 475 year: 1982 end-page: 479 ident: bib9 article-title: The choice of sedation for computed tomography in children: a prospective evaluation publication-title: Radiology contributor: fullname: Hasso – volume: 92 start-page: 471 year: 1993 end-page: 473 ident: bib5 article-title: Use of chloral hydrate for sedation in children publication-title: Pediatrics contributor: fullname: Academy of Pediatrics – volume: 65 start-page: 691 year: 1986 end-page: 692 ident: bib15 article-title: Chloral hydrate: a potential cause of arrhythmias publication-title: Anesth Analg contributor: fullname: Zauder – start-page: 33 year: 1993 end-page: 62 ident: bib1 article-title: Infants with congenital heart disease: the cases publication-title: Epidemiology of congenital heart disease: the Baltimore-Washington Infant Study. contributor: fullname: Ferencz – volume: 2 start-page: 994 year: 1977 ident: bib14 article-title: Cardiac arrhythmias caused by chloral hydrate publication-title: BMJ contributor: fullname: Marshall – volume: 27 start-page: 242 year: 1990 end-page: 244 ident: bib11 article-title: Use of high dose chloral hydrate for ophthalmic exams in children: a retrospective review of 302 cases publication-title: J Pediatr Ophthalmol Strabismus contributor: fullname: Wright – volume: 76 start-page: 317 year: 1985 end-page: 321 ident: bib3 article-title: Guidelines for the elective use of conscious sedation, deep sedation, and general anesthesia in pediatric patients publication-title: Pediatrics contributor: fullname: American Academy of Pediatrics – start-page: 1 year: 1993 end-page: 108 ident: bib8 article-title: Pediatric echocardiography contributor: fullname: Silverman – volume: 9 start-page: 162 year: 1989 end-page: 164 ident: bib16 article-title: Maintenance sedation of agitated infants in the neonatal intensive care unit with chloral hydrate: new concerns publication-title: J Perinatol contributor: fullname: Lundergan – volume: 89 start-page: 1110 year: 1992 end-page: 1115 ident: bib4 article-title: Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures publication-title: Pediatrics contributor: fullname: Academy of Pediatrics – volume: 121 start-page: 209 year: 1991 end-page: 210 ident: bib12 article-title: Midazolam nose drops for outpatient echocardiography sedation in infants publication-title: Am Heart J contributor: fullname: Hoschire – volume: 22 start-page: 408 year: 1993 end-page: 414 ident: bib7 article-title: Chloral hydrate side effects in young children: causes and management publication-title: Heart Lung contributor: fullname: Sanders – volume: 47 start-page: 134 year: 1971 end-page: 135 ident: bib13 article-title: Cardiac arrhythmia in a child due to chloral hydrate ingestion publication-title: Pediatrics contributor: fullname: Izukawa – volume: 83 start-page: 1040 year: 1990 ident: 10.1016/S0022-3476(96)70256-1_bib10 article-title: Efficacy of sedation of children with chloral hydrate publication-title: South Med J doi: 10.1097/00007611-199009000-00015 contributor: fullname: Rumm – start-page: 1 year: 1993 ident: 10.1016/S0022-3476(96)70256-1_bib8 article-title: Pediatric echocardiography contributor: fullname: Silverman – year: 1990 ident: 10.1016/S0022-3476(96)70256-1_bib6 – volume: 121 start-page: 209 year: 1991 ident: 10.1016/S0022-3476(96)70256-1_bib12 article-title: Midazolam nose drops for outpatient echocardiography sedation in infants publication-title: Am Heart J doi: 10.1016/0002-8703(91)90981-M contributor: fullname: Latson – volume: 9 start-page: 162 year: 1989 ident: 10.1016/S0022-3476(96)70256-1_bib16 article-title: Maintenance sedation of agitated infants in the neonatal intensive care unit with chloral hydrate: new concerns publication-title: J Perinatol contributor: fullname: Hartley – volume: 22 start-page: 408 year: 1993 ident: 10.1016/S0022-3476(96)70256-1_bib7 article-title: Chloral hydrate side effects in young children: causes and management publication-title: Heart Lung contributor: fullname: Lipshitz – start-page: 33 year: 1993 ident: 10.1016/S0022-3476(96)70256-1_bib1 article-title: Infants with congenital heart disease: the cases contributor: fullname: Perry – volume: 76 start-page: 317 year: 1985 ident: 10.1016/S0022-3476(96)70256-1_bib3 article-title: Guidelines for the elective use of conscious sedation, deep sedation, and general anesthesia in pediatric patients publication-title: Pediatrics contributor: fullname: Committee on Drugs – volume: 47 start-page: 134 year: 1971 ident: 10.1016/S0022-3476(96)70256-1_bib13 article-title: Cardiac arrhythmia in a child due to chloral hydrate ingestion publication-title: Pediatrics contributor: fullname: Nordenberg – volume: 92 start-page: 471 year: 1993 ident: 10.1016/S0022-3476(96)70256-1_bib5 article-title: Use of chloral hydrate for sedation in children publication-title: Pediatrics contributor: fullname: Committee on Drugs – volume: 42 start-page: 641 year: 1978 ident: 10.1016/S0022-3476(96)70256-1_bib2 article-title: Congenital heart disease in a cohort of 19,502 births with long-term follow-up publication-title: Am J Cardiol doi: 10.1016/0002-9149(78)90635-5 contributor: fullname: Hoffman – volume: 27 start-page: 242 year: 1990 ident: 10.1016/S0022-3476(96)70256-1_bib11 article-title: Use of high dose chloral hydrate for ophthalmic exams in children: a retrospective review of 302 cases publication-title: J Pediatr Ophthalmol Strabismus doi: 10.3928/0191-3913-19900901-06 contributor: fullname: Fox – volume: 65 start-page: 691 year: 1986 ident: 10.1016/S0022-3476(96)70256-1_bib15 article-title: Chloral hydrate: a potential cause of arrhythmias publication-title: Anesth Analg doi: 10.1213/00000539-198606000-00023 contributor: fullname: Hirsch – volume: 143 start-page: 475 year: 1982 ident: 10.1016/S0022-3476(96)70256-1_bib9 article-title: The choice of sedation for computed tomography in children: a prospective evaluation publication-title: Radiology doi: 10.1148/radiology.143.2.7071350 contributor: fullname: Thompson – volume: 89 start-page: 1110 year: 1992 ident: 10.1016/S0022-3476(96)70256-1_bib4 article-title: Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures publication-title: Pediatrics contributor: fullname: Committee on Drugs – volume: 2 start-page: 994 year: 1977 ident: 10.1016/S0022-3476(96)70256-1_bib14 article-title: Cardiac arrhythmias caused by chloral hydrate publication-title: BMJ doi: 10.1136/bmj.2.6093.994 contributor: fullname: Marshall |
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SubjectTerms | Adolescent Age Factors Ambulatory Care Blood Pressure - drug effects Child Child, Preschool Chloral Hydrate - administration & dosage Chloral Hydrate - adverse effects Conscious Sedation Cyanosis - diagnostic imaging Down Syndrome - diagnostic imaging Echocardiography, Doppler Heart Defects, Congenital - diagnostic imaging Heart Rate - drug effects Humans Hypnotics and Sedatives - administration & dosage Hypnotics and Sedatives - adverse effects Infant Infant, Newborn Oxygen - blood Prospective Studies Safety Time Factors Ultrasonography, Doppler, Color Ultrasonography, Doppler, Pulsed Vomiting - chemically induced |
Title | Safety and efficacy of chloral hydrate sedation in children undergoing echocardiography |
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