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. 2016 Dec;34(4):408-411.
doi: 10.1016/j.rpped.2016.05.002. Epub 2016 Jun 22.

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

[Article in English, Portuguese]
Gustavo Falbo Wandalsen  1 , Fernanda de Cordoba Lanza  2 , Márcia Cristina Pires Nogueira  3 , Dirceu Solé  3
Affiliations

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

[Article in English, Portuguese]
Gustavo Falbo Wandalsen et al. Rev Paul Pediatr. 2016 Dec.

Abstract
in English, Portuguese

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 to 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.

Objetivo:: Descrever a eficácia e a segurança do hidrato de cloral na sedação de lactentes para testes de função pulmonar.

Métodos:: Foram avaliadas retrospectivamente todas as tentativas de sedação para exames de função pulmonar em lactentes feitas entre junho 2007 e agosto 2014. Apneia obstrutiva do sono e cardiopatia foram contraindicações para os exames. Dados antropométricos, indicação do exame, dose empregada, desfechos da sedação e intercorrências clínicas foram registrados e descritos.

Resultados:: Avaliaram-se as tentativas de sedação de 277 lactentes (165 meninos) com mediana de 51,5 semanas de vida (14-182). A principal indicação para os testes foi sibilância recorrente (56%) e a dose de hidrato de cloral usada variou entre 50-80mg/kg (via oral). Dezoito (6,5%) lactentes apresentaram algum tipo de intercorrência clínica e foram as mais frequentes: tosse e/ou secreção na via aérea (1,8%); desconforto respiratório alto (1,4%) e vômitos (1,1%). Um lactente prematuro apresentou bradicardia por cerca de 15 minutos, responsiva a estimulação tátil. Todos os efeitos adversos observados foram transitórios e não houve necessidade de manobras de reanimação e uso de medicações injetáveis.

Conclusões:: Os dados demonstraram que o hidrato de cloral, nas doses empregadas, é um medicamento seguro e eficaz para a sedação de lactentes em procedimentos de curta duração, como os testes de função pulmonar. Devido à possibilidade de eventos adversos graves, as recomendações referentes à dosagem e contraindicações devem ser seguidas de forma rígida e os lactentes devem ser monitorados por equipe treinada.

Keywords: Chloral hydrate; Hidrato de cloral; Hipnóticos e sedativos; Hypnotics and sedatives; Infant; Lactente.

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Conflict of interest statement

The authors declare no conflicts of interest.

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