Safety and efficacy of chloral hydrate for conscious sedation of infants in the pediatric cardiovascular intensive care unit

Al-Raied, Fatima Ahmad (2018-04-13)

Chloral Hydrate is a synthetic monohydrate of chloral with sedative, hypnotic properties. Chloral hydrate is converted to the active compound trichloroethanol by hepatic alcohol dehydrogenase. The agent interacts with various neurotransmitter-operated ion channels, thereby enhancing gamma-aminobutyric acid(GABA)-A receptor mediated chloride currents and inhibiting amino acid receptor-activated ion currents. In addition, chloral hydrate enhances the agonistic effects of glycine receptors, inhibits AMPAinduced calcium influx in cortical neurons, and facilitates 5-HT 3 receptor-mediated currents in ganglionic neurons. Overall, this results in a depressive effect on the central nervous system. It belongs to a class of drugs known as hypnotic . It has both a fast-acting and longlasting sedative effect. Chloral hydrate is also frequently used in medical procedures. There are many other uses for this drug for example, to treat alchole withdraw symptoms or to relieve anxiety caused by withdraw from certain drugs such bacbitorates or narcotic medicine


In this report we're discussing the use of choloral hydrate for conscious sedation of infant in the pediatric cardiovascular intensive care unit PCICU .Infants with congenital cardiac malformations often have labile cardiovascular function may require sedation in the pediatric cardiovascular intensive care unit (PCICU) for several days to weeks. The infants are subject to irritating stimuli and require an adequate level of sedation while minimizing medication-related complications, respiratory inhibition, cardiovascular depression, and excessive or prolonged neurologic compromise. Chloral hydrate is one of the most commonly used sedatives in the clinical setting despite the availability of other sedatives such as midazolam and pentobarbital. It has the characteristics of ease of administration, high success rate, and transient and low prevalence of adverse reactions. Other traditional sedative agents (such as midazolam, propofol, and ketamine) can have negative effects on the respiratory drive or can have cardiovascular side effects. Based on available reports, these characteristics of chloral hydrate make it potentially useful in the treatment of infants who require sedation in a PCICU

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