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Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists.
Pediatr Radiol 2015; 45(1):108-14PR

Abstract

BACKGROUND

Chloral hydrate is a sedative that has been used for magnetic resonance imaging (MRI).

OBJECTIVE

To evaluate the use, effectiveness and safety of chloral hydrate administered by radiologists for the sedation of children who require MRI procedures.

MATERIALS AND METHODS

We retrospectively reviewed the clinical charts for all patients ages 0 - 10 years old who underwent sedation with chloral hydrate for MRI from January 2000 to December 2010. Demographic factors, dose information, indication for MRI, therapeutic failures and adverse reactions to the drug were reviewed.

RESULTS

One thousand, seven hundred and three children (946 males, 757 females) with a median age of 2.5 years (range: 4 days - 9.91 years) received chloral hydrate. Moderate to deep sedation was achieved in 1,618/1,703 (95%) of the patients, 35/1,703 (2.1%) of the patients failed to achieve moderate to deep sedation, and 47/1,703 (2.8%) of the patients woke up during MRI examination. Adverse reactions were present in 31/1,703 (1.8%) of the patients. Three severe adverse reactions occurred (0.18%). A single dose of chloral hydrate (40-60 mg/kg) was administered to 1,477/1,703 patients (86.7%). An additional dose of chloral hydrate (10-20 mg/kg), given 15 min after the first dose or when the patient woke up during the MRI examination, was required in 226/1,703 patients (13.3%). The likelihood of requiring an additional dose in children older than 2 years was 2.2 times the likelihood compared to children younger than 2 years (OR = 2.2 [95%CI: 1.6-3.0]). The use of a reduced dose (<50 mg/kg) was not associated with a higher therapeutic failure rate (OR = 1.04 [95%CI 0.57-1.89]).

CONCLUSION

Chloral hydrate is an appropriate sedation option for pediatric patients in MRI services when strict patient selection criteria are met. The use of a reduced dose does not affect the effectiveness of sedation. The lack of data regarding the presence of transient oxygen desaturation, the time to induce sedation and the exact duration of sedation are limitations of this study.

Authors+Show Affiliations

Department of Radiology, Fundación Instituto de Alta Tecnología Médica, Cra. 81 N.30A - 99, Medellin, Colombia, 050030.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25142238

Citation

Delgado, Jorge, et al. "Chloral Hydrate in Pediatric Magnetic Resonance Imaging: Evaluation of a 10-year Sedation Experience Administered By Radiologists." Pediatric Radiology, vol. 45, no. 1, 2015, pp. 108-14.
Delgado J, Toro R, Rascovsky S, et al. Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists. Pediatr Radiol. 2015;45(1):108-14.
Delgado, J., Toro, R., Rascovsky, S., Arango, A., Angel, G. J., Calvo, V., & Delgado, J. A. (2015). Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists. Pediatric Radiology, 45(1), pp. 108-14. doi:10.1007/s00247-014-3091-0.
Delgado J, et al. Chloral Hydrate in Pediatric Magnetic Resonance Imaging: Evaluation of a 10-year Sedation Experience Administered By Radiologists. Pediatr Radiol. 2015;45(1):108-14. PubMed PMID: 25142238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists. AU - Delgado,Jorge, AU - Toro,Rodrigo, AU - Rascovsky,Simon, AU - Arango,Andres, AU - Angel,Gabriel J, AU - Calvo,Victor, AU - Delgado,Jorge A, Y1 - 2014/08/21/ PY - 2014/01/28/received PY - 2014/06/16/accepted PY - 2014/05/15/revised PY - 2014/8/22/entrez PY - 2014/8/22/pubmed PY - 2015/9/9/medline SP - 108 EP - 14 JF - Pediatric radiology JO - Pediatr Radiol VL - 45 IS - 1 N2 - BACKGROUND: Chloral hydrate is a sedative that has been used for magnetic resonance imaging (MRI). OBJECTIVE: To evaluate the use, effectiveness and safety of chloral hydrate administered by radiologists for the sedation of children who require MRI procedures. MATERIALS AND METHODS: We retrospectively reviewed the clinical charts for all patients ages 0 - 10 years old who underwent sedation with chloral hydrate for MRI from January 2000 to December 2010. Demographic factors, dose information, indication for MRI, therapeutic failures and adverse reactions to the drug were reviewed. RESULTS: One thousand, seven hundred and three children (946 males, 757 females) with a median age of 2.5 years (range: 4 days - 9.91 years) received chloral hydrate. Moderate to deep sedation was achieved in 1,618/1,703 (95%) of the patients, 35/1,703 (2.1%) of the patients failed to achieve moderate to deep sedation, and 47/1,703 (2.8%) of the patients woke up during MRI examination. Adverse reactions were present in 31/1,703 (1.8%) of the patients. Three severe adverse reactions occurred (0.18%). A single dose of chloral hydrate (40-60 mg/kg) was administered to 1,477/1,703 patients (86.7%). An additional dose of chloral hydrate (10-20 mg/kg), given 15 min after the first dose or when the patient woke up during the MRI examination, was required in 226/1,703 patients (13.3%). The likelihood of requiring an additional dose in children older than 2 years was 2.2 times the likelihood compared to children younger than 2 years (OR = 2.2 [95%CI: 1.6-3.0]). The use of a reduced dose (<50 mg/kg) was not associated with a higher therapeutic failure rate (OR = 1.04 [95%CI 0.57-1.89]). CONCLUSION: Chloral hydrate is an appropriate sedation option for pediatric patients in MRI services when strict patient selection criteria are met. The use of a reduced dose does not affect the effectiveness of sedation. The lack of data regarding the presence of transient oxygen desaturation, the time to induce sedation and the exact duration of sedation are limitations of this study. SN - 1432-1998 UR - https://www.unboundmedicine.com/medline/citation/25142238/Chloral_hydrate_in_pediatric_magnetic_resonance_imaging:_evaluation_of_a_10_year_sedation_experience_administered_by_radiologists_ L2 - https://dx.doi.org/10.1007/s00247-014-3091-0 DB - PRIME DP - Unbound Medicine ER -