Cardiorespiratory parameters in newborns during sedation with chloral hydrate

We commonly use chloral hydrate sedation in newborns, though its cardiorespiratory side effects have not yet been fully investigated. Our study aimed to analyze the impact of chloral hydrate on cardiorespiratory parameters in term newborns. We performed a prospective, pre-post single-arm interventional study in 42 term, respiratorily and hemodynamically stable newborns. Oxygen saturation (SpO2), end-tidal CO2 (ETCO2), the apnea-hypopnea index and the respiratory and heart rates were recorded by polygraphy, starting 0.5-1 hour before oral administration of chloral hydrate at a dose of 40 mg/kg and ceasing 4 hours post-administration. After administration of chloral hydrate, the mean basal SpO2 dropped by 2.0% (from 97.1% to 95.1%; p

___

1.Avlonitou E, Balatsouras DG, Margaritis E, Giannakopoulos P, Douniadakis D, Tsakanikos M. Use of chloral hydrate as a sedative for auditory brainstem response testing in a pediatric population. Int J Pediatr Otorhinolaryngol 2011; 75: 760-763.

2.Allegaert K, Daniels H, Naulaers G, Tibboel D, Devlieger H. Pharmacodynamics of chloral hydrate in former preterm infants. Eur J Pediatr 2005; 164: 403-407.

3.Heistein LC, Ramaciotti C, Scott WA, Coursey M, Sheeran PW, Lemler MS. Chloral hydrate sedation for pediatric echocardiography: physiologic responses, adverse events, and risk factors. Pediatrics 2006; 117: e434-e441.

4.Finnemore A, Toulmin H, Merchant N, et al. Chloral hydrate sedation for magnetic resonance imaging in newborn infants. Paediatr Anaesth 2014; 24: 190-195.

5.Marchi A, Orrù A, Manai ME, Chelo C, Lettieri B, Corbucci GG. Deep sedation for magnetic resonance imaging. Personal experience. Minerva Anestesiol 2004; 70: 53-61.

6.Jacqz-Aigrain E, Burtin P. Clinical pharmacokinetics of sedatives in neonates. Clin Pharmacokinet 1996; 31: 423-443.

7.Sezer T, Alehan F. Chloral hydrate versus hydroxyzine HCl for sedation prior to pediatric sleep EEG recording. Int J Neurosci 2013; 123: 719-723.

8.Treluyer JM, Andre C, Carp PF, et al. Sedation in children undergoing CT scan or MRI: effect of time-course and tolerance of rectal chloral hydrate. Fundam Clin Pharmacol 2004; 18: 347-350.

9.Sanatkar M, Ghassemi F, Khodabande A, et al. Use of chloral hydrate as a sedative agent before general anesthesia in pediatric population undergoing eye examination. Arch Anesthesiol Crit Care 2015; 1: 80-83.

10.Cortellazzi P, Lamperti M, Minati L, Falcone C, Pantaleoni C, Caldiroli D. Sedation of neurologically impaired children undergoing MRI: a sequential approach. Paediatr Anaesth 2007; 17: 630-636.

11.Nordt SP, Rangan C, Hardmaslani M, Clark RF, Wendler C, Valente M. Pediatric chloral hydrate poisonings and death following outpatient procedural sedation. J Med Toxicol 2014; 10: 219-222.

12.Coté CJ, Wilson S. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics 2006; 118: 2587-2602.

13.Mace SE, Brown LA, Francis L, et al. Clinical policy: critical issues in the sedation of pediatric patients in the emergency department. Ann Emerg Med 2008; 51: 378-399. e1-e57.

14.Reynolds J, Rogers A, Capehart S, Manyang P, Watcha MF. Retrospective comparison of intranasal dexmedetomidine and oral chloral hydrate for sedated auditory brainstem response exams. Hosp Pediatr 2016; 6: 166-171.

15.Mayers DJ, Hindmarsh KW, Sankaran K, Gorecki DK, Kasian GF. Chloral hydrate disposition following single-dose administration to critically ill neonates and children. Dev Pharmacol Ther 1991; 16: 71-77.

16.Litman RS, Soin K, Salam A. Chloral hydrate sedation in term and preterm infants: an analysis of efficacy and complications. Anesth Analg 2010; 110: 739-746.

17.Malviya S, Voepel-Lewis T, Tait AR. Adverse events and risk factors associated with the sedation of children by nonanesthesiologists. Anesth Analg 1997; 85: 1207-1213.

18.Coates BM, Chaize R, Goodman DM, Rozenfeld RA. Performance of capnometry in non-intubated infants in the pediatric intensive care unit. BMC Pediatr 2014; 14: 163.

19.Tai CC, Lu FL, Chen PC, et al. Noninvasive capnometry for end-tidal carbon dioxide monitoring via nasal cannula in nonintubated neonates. Pediatr Neonatol 2010; 51: 330-335.

20.Hagerty JJ, Kleinman ME, Zurakowski D, Lyons AC, Krauss B. Accuracy of a new low-flow sidestream capnography technology in newborns: a pilot study. J Perinatol 2002; 22: 219-225.

21.O'Leary F, Hayen A, Lockie F, Peat J. Defining normal ranges and centiles for heart and respiratory rates in infants and children: a cross-sectional study of patients attending an Australian tertiary hospital paediatric emergency department. Arch Dis Child 2015; 100: 733-737.

22.Fleming S, Thompson M, Stevens R, et al. Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. Lancet 2011; 377: 1011-1018.

23.Ng DK, Chan CH. A review of normal values of infant sleep polysomnography. Pediatr Neonatol 2013; 54: 82-87.

24.Terrill PI, Dakin C, Hughes I, Yuill M, Parsley C. Nocturnal oxygen saturation profiles of healthy term infants. Arch Dis Child 2015; 100: 18-23.

25.Shah PS, Hakak H, Mohamed A, Shah J, Young J, Kelly E. Oxygen saturation profile in late-preterm and term infants: a prospective cohort study. J Perinatol 2014; 34: 917-920.

26.Krauss B, Hess DR. Capnography for procedural sedation and analgesia in the emergency department. Ann Emerg Med 2007; 50: 172-181.

27.Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012; 8: 597-619.

28.Gaultier C. Review article: Sleep apnea in infants. Sleep Med Rev 1999; 3: 303-312.

29.Farré R, Montserrat JM, Rotger M, Ballester E, Navajas D. Accuracy of thermistors and thermocouples as flow-measuring devices for detecting hypopnoeas. Eur Respir J 1998; 11: 179-182.

30.Coskun S, Yuksel H, Onag A. Chloralhydrate in children undergoing echocardiography. Indian J Pediatr 2001; 68: 319-322.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler

Peters Plus syndrome: a recognizable clinical entity

Gizem ÜREL DEMİR, Naz Güleray LAFCI, Özlem AKGÜN DOĞAN, Pelin Özlem ŞİMŞEK KİPER, Gülen Eda UTİNE

Mother-child interaction and the development status of children who have been accidentally poisoned

Ganime AYAR, Tülin KÖKSAL, Funda VURAL KURT, Aysun KARA UZUN, Bahar ÇUHACI ÇAKIR, Birgül BAYOĞLU, Sıddıka Songül YALÇIN

Assessment of motor development using the Alberta Infant Motor Scale in full-term infants

Büşra KEPENEK VAROL, Zeynep HOŞBAY, Hüseyin Selçuk VAROL, Emel TORUN

Dropped head related lamin A/C associated congenital muscular dystrophy case; previously defined as emery-dreifuss muscular dystrophy

Hande GAZATECİ TEKİN, Sabire Sanem YILMAZ, Hasan TEKGÜL, Sarenur GÖKBEN, Gül AKTAN

Evaluation of pentraxin 3 level and cardiac functions in psoriatic children

Mecnun ÇETİN, İbrahim Halil YAVUZ, Göknur ÖZAYDIN YAVUZ, Kamuran KARAMAN

A rare presentation of adrenal adenoma in infancy: isolated Cushing’s syndrome

Oğuzhan ŞAL, Gülçin YEĞEN, Pelin OĞUZKURT

Risk factors of intravenous immunoglobulin resistance and coronary arterial lesions in Turkish children with Kawasaki disease

Serkan TÜRKUÇAR, Kaan YILDIZ, Ceyhun ACARI, Hatice ADIGÜZEL DUNDAR, Mustafa Çağlar KIR, Erbil ÜNSAL

A novel homozygous nonsense mutation (p.Y78*) in TMPRSS6 gene causing iron-refractory iron deficiency anemia (IRIDA) in two siblings

Seda ÇAKMAKLI, Çiğdem BUĞAN KAPLAN, Mehmet UZUNOĞLU, Merve BÜYÜKBAYRAM, Emel GÖRGÜLÜ, Nurten ÖZKAN ZARİF, Ebru KESKİN

Rotavirus encephalopathy with concomitant acute cerebellitis: report of a case and review of the literature

Cem PAKETÇİ, Pınar EDEM, Derya OKUR, Fatma Ceren SARIOĞLU, Handan GÜLERYÜZ, Erhan BAYRAM, Semra Hız KURUL, Uluç YİŞ

Grisel’s syndrome presenting with neck pain: an atypical case

Emre BİLGİN, Gökhan ÇAVUŞ, Vedat AÇIK, Yurdal GEZERCAN, Ali İhsan ÖKTEN