Neonatal Med.  2019 May;26(2):85-90. 10.5385/nm.2019.26.2.85.

Adverse Events and Risk Factors Associated with Chloral Hydrate Sedation for Brain Magnetic Resonance Imaging in the Neonatal Intensive Care Unit

• Park BS
• Yoo YM
• Noh OK
• Park MS
• Lee JH

• KMID: 2451605
• DOI: http://doi.org/10.5385/nm.2019.26.2.85

Abstract

PURPOSE
This study investigated the incidence of adverse events (AEs) and risk factors associated with sedation using chloral hydrate (CH) for brain magnetic resonance imaging (MRI) in the neonatal intensive care unit (NICU).
METHODS
This was a retrospective study of infants who received CH for brain MRI in the NICU. Among the enrolled infants (n=143), 12.6% (n=18) were included in the AE group and 87.4% (n=125) were in the non-adverse event group (NAE).
RESULTS
Gestational age (GA) at birth and corrected GA at sedation were 35+0±7+2 and 39+5±3+1 respectively. The rate of AEs was 12.6%, included oxygen desaturation (5.6%), aspiration (4.9%), paradoxical agitation (0.7%), tachycardia or bradycardia (0.7%), and arrest (0.7%). In univariate analysis, the AE group was younger in corrected GA at sedation than the NAE group (37+2 [range, 36+0 to 40+0] vs. 40+1 [range, 38+2 to 41+4], P=0.015). There was no significant difference in CH dosage (50.0 [range, 50.0 to 50.0] vs. 50.0 [range, 50.0 to 50.0], P=0.092), cardiopulmonary (33.3% [n=6] vs. 17.6% [n= 22], P=0.209) and central nervous system (61.1% [n=11] vs. 65.6% [n=82], P=0.054) morbidity. In multivariate analysis, CH dosage was the only significant risk factor for AEs associated with sedation (odds ratio, 1.04; 95% confidence interval, 1.01 to 1.07; P=0.0186).
CONCLUSION
AEs associated with sedation using CH are not uncommon and should be considered when using high dose CH for diagnostic testing in the NICU.

Keyword

Chloral hydrate; Infant, newborn; Adverse effects

MeSH Terms

Bradycardia
Brain*
Central Nervous System
Chloral Hydrate*
Diagnostic Tests, Routine
Dihydroergotamine
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Intensive Care, Neonatal*
Magnetic Resonance Imaging*
Multivariate Analysis
Oxygen
Parturition
Retrospective Studies
Risk Factors*
Tachycardia
Chloral Hydrate
Dihydroergotamine
Oxygen

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