دورية أكاديمية
Comparative safety profile of chloral hydrate versus other sedatives for procedural sedation in hospitalized infants.
| العنوان: | Comparative safety profile of chloral hydrate versus other sedatives for procedural sedation in hospitalized infants. |
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| المؤلفون: | Dallefeld SH; Pediatric Intensive Care Unit, Dell Children's Medical Center of Central Texas, Austin, TX, USA.; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Smith PB; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Crenshaw EG; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Daniel KR; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Gilleskie ML; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Smith DS; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Balevic S; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Greenberg RG; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Chu V; Department of Medicine, Duke University Medical Center, Durham, NC, USA., Clark R; Pediatrix Medical Group, Inc, Sunrise, FL, USA., Kumar KR; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA., Zimmerman KO; Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA. |
| المصدر: | Journal of neonatal-perinatal medicine [J Neonatal Perinatal Med] 2020; Vol. 13 (2), pp. 159-165. |
| نوع المنشور: | Comparative Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: IOS Press Country of Publication: Netherlands NLM ID: 101468335 Publication Model: Print Cited Medium: Internet ISSN: 1878-4429 (Electronic) Linking ISSN: 18784429 NLM ISO Abbreviation: J Neonatal Perinatal Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Amsterdam : IOS Press, 2008- |
| مواضيع طبية MeSH: | Hospitalization*, Chloral Hydrate/*therapeutic use , Hypnotics and Sedatives/*therapeutic use , Respiratory Insufficiency/*chemically induced, Diagnostic Imaging/methods ; Diagnostic Techniques, Ophthalmological ; Electroencephalography/methods ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Lorazepam/therapeutic use ; Male ; Midazolam/therapeutic use ; Multivariate Analysis ; Oxygen Inhalation Therapy ; Pentobarbital/therapeutic use ; Polysomnography/methods ; Propensity Score ; Respiration, Artificial ; Respiratory Insufficiency/therapy |
| مستخلص: | Background: Given the limited available evidence on chloral hydrate safety in neonatal populations and the discrepancy in chloral hydrate acceptance between the US and other countries, we sought to clarify the safety profile of chloral hydrate compared to other sedatives in hospitalized infants. Methods: We included all infants <120 days of life who underwent a minor procedure and were administered chloral hydrate, clonidine, clonazepam, dexmedetomidine, diazepam, ketamine, lorazepam, midazolam, propofol, or pentobarbital on the day of the procedure. We characterized the distribution of infant characteristics and evaluated the relationship between drug administration and any adverse event. We performed propensity score matching, regression adjustment (RA), and inverse probability weighting (IPW) to ensure comparison of similar infants and to account for confounding by indication and residual bias. Results were assessed for robustness to analytical technique by reanalyzing the main outcomes with multivariate logistic regression, a doubly robust IPW with RA model, and a doubly robust augmented IPW model with bias-correction. Results: Of 650 infants, 497 (76%) received chloral hydrate, 79 (12%) received midazolam, 54 (8%) received lorazepam, and 15 (2%) received pentobarbital. Adverse events occurred in 41 (6%) infants. Using propensity score matching, chloral hydrate was associated with a decreased risk of an adverse event compared to other sedatives, risk difference (95% confidence interval) of -12.79 (-18.61, -6.98), p < 0.001. All other statistical methods resulted in similar findings. Conclusion: Administration of chloral hydrate to hospitalized infants undergoing minor procedures is associated with a lower risk for adverse events compared to other sedatives. |
| فهرسة مساهمة: | Keywords: Comfort drugs; adverse events; analgesic; sedative |
| المشرفين على المادة: | 0 (Hypnotics and Sedatives) 418M5916WG (Chloral Hydrate) I4744080IR (Pentobarbital) O26FZP769L (Lorazepam) R60L0SM5BC (Midazolam) |
| تواريخ الأحداث: | Date Created: 20200616 Date Completed: 20210419 Latest Revision: 20210419 |
| رمز التحديث: | 20231215 |
| DOI: | 10.3233/NPM-190214 |
| PMID: | 32538879 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1878-4429 |
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| DOI: | 10.3233/NPM-190214 |