INTRODUCTION: Chloral hydrate has been used medicinally since the 1800 s as a sedative hypnotic, most commonly for procedural sedation. As it is administered orally and available in a liquid formulation, it is used almost exclusively in pediatric patients despite many safer and more effective alternative agents being available. CASE SERIES: We present three cases of pediatric chloral hydrate poisoning, all occurring following procedural sedation in outpatient clinic settings and presenting to the emergency department. The ages ranged from 15 months to 4 years of age and all required resuscitation. Unfortunately, the 4-year-old died. CONCLUSION: Choral hydrate is associated with significant adverse effects, including death, and safer alternatives for pediatric procedural sedation should be sought and utilized. There are a number of more effective sedative agents with more predictable pharmacokinetic and safety profiles than chloral hydrate including parenteral and oral agents. The practice of pre-procedure sedation should be performed only in a supervised setting where cardiorespiratory monitoring can occur in all cases.
INTRODUCTION:Chloral hydrate has been used medicinally since the 1800 s as a sedative hypnotic, most commonly for procedural sedation. As it is administered orally and available in a liquid formulation, it is used almost exclusively in pediatric patients despite many safer and more effective alternative agents being available. CASE SERIES: We present three cases of pediatric chloral hydratepoisoning, all occurring following procedural sedation in outpatient clinic settings and presenting to the emergency department. The ages ranged from 15 months to 4 years of age and all required resuscitation. Unfortunately, the 4-year-old died. CONCLUSION: Choral hydrate is associated with significant adverse effects, including death, and safer alternatives for pediatric procedural sedation should be sought and utilized. There are a number of more effective sedative agents with more predictable pharmacokinetic and safety profiles than chloral hydrate including parenteral and oral agents. The practice of pre-procedure sedation should be performed only in a supervised setting where cardiorespiratory monitoring can occur in all cases.
Authors: Sharon E Mace; Lance A Brown; Lisa Francis; Steven A Godwin; Sigrid A Hahn; Patricia Kunz Howard; Robert M Kennedy; David P Mooney; Alfred D Sacchetti; Robert L Wears; Randall M Clark Journal: Ann Emerg Med Date: 2008-04 Impact factor: 5.721
Authors: Jeong Yong Lee; Seung Jun Choi; Jun Sung Park; Jong Seung Lee; Jeong Min Ryu; Mi Sun Yum Journal: J Korean Med Sci Date: 2021-08-23 Impact factor: 2.153