Efficacy and safety of chloral hydrate sedation in infants for pulmonary function tests

Abstract

Objective:To describe the efficacy and safety of chloral hydrate sedation in infants for pulmonary function tests.Methods:All sedation attempts for pulmonary function tests in infants carried out between June 2007 and August 2014 were evaluated. Obstructive sleep apnea and heart disease were contraindications to the exams. Anthropometric data, exam indication, used dose, outcomes of sedation and clinical events were recorded and described.Results:The sedation attempts in 277 infants (165 boys) with a median age of 51.5 weeks of life (14-182 weeks) were evaluated. The main indication for the tests was recurrent wheezing (56%) and the chloral hydrate dose ranged from 50 to 80mg/kg (orally). Eighteen (6.5%) infants had some type of clinical complication, with the most frequent being cough and/or airway secretion (1.8%); respiratory distress (1.4%) and vomiting (1.1%). A preterm infant had bradycardia for approximately 15 minutes, which was responsive to tactile stimulation. All observed adverse effects were transient and there was no need for resuscitation or use of injectable medications.Conclusions:The data demonstrated that chloral hydrate at the employed doses is a safe and effective medicament for sedation during short procedures in infants, such as pulmonary function tests. Because of the possibility of severe adverse events, recommendations on doses and contraindications should be strictly followed and infants should be monitored by trained staff.

Pulmonary function in former very low birth weight preterm infants in the first year of life

“…A limitation of this study is the small sample size analyzed, which resulted from the difficulty in obtaining acceptance from parents to allow pulmonary function tests needing sedation to be conducted on asymptomatic children, or on children for whom the indication of these tests is questionable from the clinical point of view. The use of chloral hydrate is not without risk, especially in preterm infants with reports of bradycardia, oxygen saturation drops and prolonged sedative effects [28,29]. A further limitation is related to this being a cross-sectional study and therefore not allowing the inference of causal relationships for the risk factors found for alterations in pulmonary function.…”

Pulmonary Gas Exchange Improves over the First Year in Preterm Infants with and without Bronchopulmonary Dysplasia

“…The limitations of our study include the small sample size of VP BPD infants, no measurement of day-to-day variability of the shift test [29], and the absence of longitudinal data in the term cohort. Chloral hydrate used for sedating infants at 1-year assessment does not influence the peripheral oxygen saturation when used alone [30, 31].…”

Association between thoracic musculoskeletal abnormalities and lung function in preterm infants

“…Pulmonary function tests were performed after sedation with chloral hydrate (50‐80 mg/kg), according to laboratory protocol; patients' heart rate and peripheral oxygen saturation were continuously monitored during the tests.…”

“…Musculoskeletal abnormalities resulting from increasing respiratory effort can be evaluated by photogrammetry, a technique that uses computer programs for detecting musculoskeletal disorders in children born prematurely . This method could be an interesting alternative for an indirect evaluation of pulmonary conditions, once numerous difficulties and advices are experienced when lung function tests in infants are performed …”