Objective To compare efficacy and safety of two moderate sedation regimens for transthoracic echocardiography (TTE): intranasal dexmedetomidine–midazolam (DM) versus oral chloral hydrate (CH) syrup.
Method This was a retrospective cohort of 93 children under 4 years of age receiving moderate sedation with either DM or CH for TTE from January 2011 through December 2014.
Measurements and Main Results Forty-nine patients received oral CH and 44 received the intranasal combination of DM. The demographics between groups were similar except the DM patients were slightly older and heavier (each p < 0.05). Failure rate between groups did not reach statistical significance (CH 14.3% vs. DM 6.8%; p = 0.324). Total sedation to discharge time was similar between groups (CH 89.4 minutes vs. DM 89.6 minute; p = 0.97). Cardiopulmonary data did reveal a significantly lower heart rate (101.9 vs. 91.7; p < 0.001) and respiratory rate (23.4 vs. 21.0, p = 0.03) in the DM group, but no difference in blood pressure measurements or echo determined shortening fraction.
Conclusion These data support the use of intranasal DM as a safe and efficacious method of moderate sedation for children undergoing TTE.
The Ehlers-Danlos syndromes (EDS) represent a genetically and clinically heterogeneous group of inherited connective tissue diseases (for a review see Malfait et al., 2020) that share clinical features including joint hypermobility, tissue fragility, and skin changes with a spectrum of severity that goes from subclinical to life-threatening. The 2017 international Ehlers-Danlos syndrome classification describes 13 different types of EDS and a fourteenth rare subtype has recently been identified (Blackburn et al., 2018;Malfait et al., 2017). Variants in 20 distinct genes can cause
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