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J Pediatr Intensive Care 2017; 06(03): 182-187
DOI: 10.1055/s-0036-1597696
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Comparative Effectiveness of Intranasal Dexmedetomidine–Midazolam versus Oral Chloral Hydrate Targeting Moderate Sedation during Pediatric Transthoracic Echocardiograms

Jordan Fett
1   Michigan State University College of Human Medicine, East Lansing, Michigan, United States
,
Richard Hackbarth
1   Michigan State University College of Human Medicine, East Lansing, Michigan, United States
2   Division of Critical Care, Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States
,
Brian M. Boville
1   Michigan State University College of Human Medicine, East Lansing, Michigan, United States
2   Division of Critical Care, Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States
,
Anthony D. Olivero
1   Michigan State University College of Human Medicine, East Lansing, Michigan, United States
2   Division of Critical Care, Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States
,
Alan T. Davis
3   Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan, United States
,
John W. Winters
1   Michigan State University College of Human Medicine, East Lansing, Michigan, United States
2   Division of Critical Care, Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States
› Author Affiliations
Further Information

Publication History

03 September 2016

21 November 2016

Publication Date:
26 December 2016 (online)

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Abstract

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.

Keywords

intranasal dexmedetomidine–midazolam - chloral hydrate - transthoracic echocardiography
 

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