Comparison of intranasal midazolam, intranasal ketamine, and oral chloral hydrate for conscious sedation during paediatric echocardiography: results of a prospective randomised study.

Abstract:

OBJECTIVE:There are several agents used for conscious sedation by various routes in children. The aim of this prospective randomised study is to compare the effectiveness of three commonly used sedatives: intranasal ketamine, intranasal midazolam, and oral chloral hydrate for children undergoing transthoracic echocardiography. METHODS:Children who were referred to paediatric cardiology due to a heart murmur for transthoracic echocardiography were prospectively randomised into three groups. Seventy-three children received intranasal midazolam (0.2 mg/kg), 72 children received intranasal ketamine (4 mg/kg), and 72 children received oral chloral hydrate (50 mg/kg) for conscious sedation. The effects of three agents were evaluated in terms of intensity, onset, and duration of sedation. Obtaining high-quality transthoracic echocardiography images (i.e. absence of artefacts) were regarded as successful sedation. Side effects due to medications were also noted. RESULTS:There was no statistical difference in terms of sedation success rates between three groups (95.9, 95.9, and 94.5%, respectively). The median onset of sedation in the midazolam, ketamine, and chloral hydrate was 14 minutes (range 7-65), 34 minutes (range 12-56), and 40 minutes (range 25-57), respectively (p < 0.001 for all). However, the median duration of sedation in study groups was 68 minutes (range 20-75), 55 minutes (range 25-75), and 61 minutes (range 34-78), respectively (p = 0.023, 0.712, and 0.045). Gastrointestinal side effects such as nausea and vomiting were significantly higher in the chloral hydrate group (11.7 versus 0% for midazolam and 2.8% for ketamine, respectively, p = 0.002). CONCLUSION:Results of our prospectively randomised study indicate that all three agents provide adequate sedation for successful transthoracic echocardiography. When compared the three sedatives, intranasal midazolam has a more rapid onset of sedation while intranasal ketamine has a shorter duration of sedation. Intranasal ketamine can be used safely with fewer side effects in children undergoing transthoracic echocardiography.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Alp H,Elmacı AM,Alp EK,Say B

doi

10.1017/S1047951119001835

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1189-1195

issue

9

eissn

1047-9511

issn

1467-1107

pii

S1047951119001835

journal_volume

29

pub_type

杂志文章,随机对照试验
  • The relationship between Maude Abbott and Helen Taussig: connecting the historical dots.

    abstract::The literature has scant documentation of the relationship between the important founders of paediatric cardiology, Maude Abbott and Helen Taussig. Recently discovered entries in the diaries kept by Maude Abbott provide evidence for a close connection between them. Further evidence suggests that their association was ...

    journal_title:Cardiology in the young

    pub_type: 传,历史文章,杂志文章

    doi:10.1017/S1047951108002771

    authors: Evans WN

    更新日期:2008-12-01 00:00:00

  • Scimitar syndrome in a case with VACTERL association.

    abstract::VACTERL association and Scimitar syndrome are rare congenital diseases. In this study, we report on a neonate with prenatal suspicion of VACTERL association and small left-sided cardiac structures, which, only on postnatal angiography, could be revealed to be part of a Scimitar syndrome. As this is the second reported...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951114000924

    authors: Fritz CJ,Reutter HM,Herberg U

    更新日期:2015-03-01 00:00:00

  • Sudden cardiac death associated with premature atheroma in the young: an autopsy study emphasising single-vessel lesions.

    abstract:UNLABELLED:Aims This is the first autopsy study in the United Kingdom to analyse the demographic and pathological characteristics of atheroma associated with sudden cardiac death in young people. METHODS:An observational retrospective study of referred cases of sudden cardiac death in the young (⩽35 years) associated ...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951115001286

    authors: Green AC,Sheppard MN

    更新日期:2016-04-01 00:00:00

  • Endocarditis of a congenital coronary fistula in a child.

    abstract::Endocarditis of congenital coronary fistulas in the cardiac chambers is rare, especially in the paediatric age group. We describe the case of a 9-year-old boy with a fistula from the dilated right coronary artery to the junction of the superior caval vein to the right atrium, complicated by endocarditis. Treatment con...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951117001846

    authors: Krasemann T,van Beynum IM,Frohn-Mulder IME,Dalinghaus M

    更新日期:2018-02-01 00:00:00

  • Propofol as a bridge to extubation for high-risk children with congenital cardiac disease.

    abstract:BACKGROUND:Children with congenital cardiac defects may have associated chromosomal anomalies, airway compromise, and/or pulmonary hypertension, which can pose challenges to adequate sedation, weaning from mechanical ventilation, and successful extubation. Propofol, with its unique properties, may be used as a bridge t...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951110001344

    authors: Teng SN,Kaufman J,Czaja AS,Friesen RH,da Cruz EM

    更新日期:2011-02-01 00:00:00

  • Fever without a source in children with congenital heart disease.

    abstract::Two paediatric congenital heart disease patients presented with a brief history of low-grade fever without any focal symptoms. Their clinical features and laboratory tests were unremarkable; however, their blood cultures were positive that prompted further work-up. Infective endocarditis should be considered in any pa...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S104795112000195X

    authors: DonaireGarcia A,Burke B,Latifi SQ,Agarwal HS

    更新日期:2020-09-01 00:00:00

  • Role of toxicological determinations of amphetamines and cannabinoids in hair of adolescent patients in cardiologic diagnostic management.

    abstract:BACKGROUND:Parental suspicions that the child may possibly take narcotics may be substantiated by hair analysis, which may not only identify the narcotic abuse profile, but also define the minimum period of narcotic usage. OBJECTIVE:A toxicological hair analysis aiming at detecting the presence of amphetamines and can...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951111000667

    authors: Kłys M,Szydłowski L,Rojek S

    更新日期:2012-02-01 00:00:00

  • Atretic anomalous left subclavian artery as part of an unusual vascular ring.

    abstract::In this report, a unique case of a symptomatic vascular ring formed by right aortic arch, aberrant left subclavian artery, and left ligamentum arteriosus in which there is atresia of the proximal left subclavian artery is described. Imaging modalities were non-diagnostic and the patient was sent to surgery based on st...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951118001737

    authors: Powell SK,Patel JK,Ebenroth ES

    更新日期:2019-01-01 00:00:00

  • Percutaneous transcatheter occlusion of the patent arterial duct using the pfm DuctOcclud Coil via a trans-aortic and trans-pulmonary approach.

    abstract::Occlusion using coils is now the treatment of choice for closure of the patent arterial duct. The DuctOcclud (pfm AG, Cologne, Germany) device is a relatively new retrievable coil for such trans-catheter closure. This study expands on previously reported experience with this device, summarizes the advantages of the de...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/s1047951102000793

    authors: Friedberg M,Khoury A,Schwartz Y,Braver Y,Lorber A

    更新日期:2002-10-01 00:00:00

  • Kawasaki disease with tsutsugamushi disease: two case reports.

    abstract::A number of microorganisms were hypothesised as an aetiology of the Kawasaki disease. Unfortunately, no specific agent that provides reproducible evidence has yet been reported. We report two cases of extremely rare Kawasaki disease with tsutsugamushi disease. These case reports suggest that Kawasaki disease can rarel...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951120000931

    authors: Hwang HS,Kim YJ,Song MS

    更新日期:2020-06-01 00:00:00

  • Anakinra as rescue therapy for steroid-dependent idiopathic recurrent pericarditis in children: case report and literature review.

    abstract::In approximately 5% of patients with idiopathic recurrent pericarditis, the disease usually follows a chronic relapsing course, and children can develop dependence and side effects of prolonged high-dose corticosteroid regimens. In this setting anakinra, a recombinant human interleukin-1 competitive receptor antagonis...

    journal_title:Cardiology in the young

    pub_type: 杂志文章,评审

    doi:10.1017/S1047951118002020

    authors: Rodriguez-Gonzalez M,Ruiz-Gonzalez E,Castellano-Martinez A

    更新日期:2019-02-01 00:00:00

  • Systemic hypertension in an infant with unrepaired tetralogy of Fallot: case report.

    abstract::Patients with severe right ventricular outflow tract obstruction in tetralogy of Fallot typically have right-to-left shunting, resulting in low pulmonary blood flow and cyanosis. Here we present the case of an infant with tetralogy of Fallot and severe pulmonary valve stenosis, complicated by systemic hypertension, th...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951112001837

    authors: Khoury M,Kallile M,May J,Punn R

    更新日期:2013-10-01 00:00:00

  • Characteristics and outcomes of children with congenital heart disease needing diaphragm plication.

    abstract:BACKGROUND:Diaphragm dysfunction following surgery for congenital heart disease is a known complication leading to delays in recovery and increased post-operative morbidity and mortality. We aimed to determine the incidence of and risk factors associated with diaphragm plication in children undergoing cardiac surgery a...

    journal_title:Cardiology in the young

    pub_type: 杂志文章,多中心研究

    doi:10.1017/S1047951119002671

    authors: Foster CB,Cabrera AG,Bagdure D,Blackwelder W,Moffett BS,Holloway A,Mishcherkin V,Bhutta A

    更新日期:2020-01-01 00:00:00

  • Diagnosis, clinical features, management, and post-natal follow-up of fetal tachycardias.

    abstract:OBJECTIVE:To evaluate the diagnosis, clinical features, management and post-natal follow-up in consecutive fetuses identified with tachycardia. METHODS:We reviewed consecutive fetuses with tachycardia identified in a single tertiary institution between January, 2001, and December, 2008. We considered several options f...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951109990497

    authors: Lulić Jurjević R,Podnar T,Vesel S

    更新日期:2009-09-01 00:00:00

  • Endomyocardial fibrosis in children.

    abstract::We describe 10 children with endomyocardial fibrosis who underwent surgical treatment between 1978 and 1999. Seven were male and 3 female, with an age range from 4 to 15 years, having a mean age of 11 years. All were in the final stage of heart failure. Three had biventricular disease, 6 had involvement of the right v...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/s1047951101000129

    authors: Santos CL,Moraes CR,Santos FL,Moraes F,Brindeiro Filho D

    更新日期:2001-03-01 00:00:00

  • Pulmonary vascular resistance index and mortality after paediatric heart transplant.

    abstract:BACKGROUND:Although some prior studies have provided evidence to question the historical belief that pulmonary vascular resistance index ⩾6 Wood Units×m2 should be a contraindication to heart transplantation in children, no national analyses specific to the modern area have addressed this question. METHODS:Data were a...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951114001796

    authors: Maxwell BG,Sheikh AY,Ajuba-Iwuji CC,Heitmiller ES,Vricella LA

    更新日期:2015-08-01 00:00:00

  • Ameliorative role of gemfibrozil against partial abdominal aortic constriction-induced cardiac hypertrophy in rats.

    abstract::Fibrates are peroxisome proliferator-activated receptor-α agonists and are clinically used for treatment of dyslipidemia and hypertriglyceridemia. Fenofibrate is reported as a cardioprotective agent in various models of cardiac dysfunction; however, limited literature is available regarding the role of gemfibrozil as ...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S104795111400081X

    authors: Singh AP,Singh R,Krishan P

    更新日期:2015-04-01 00:00:00

  • Berry syndrome: the importance of genetic evaluation before surgical intervention.

    abstract::Berry syndrome is a rare CHD. Approximately 29 cases have been described in the literature. Surgical correction has been successfully performed as well. We report the case of a newborn diagnosed with Berry syndrome who was subsequently diagnosed with trisomy 13. Cytogenetic analysis should be performed before surgical...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951115000256

    authors: Remon JI,Briston DA,Stern KW

    更新日期:2016-01-01 00:00:00

  • Family history of associated disorders in patients with postural tachycardia syndrome.

    abstract:INTRODUCTION:Postural tachycardia syndrome is more frequently being recognised in adolescents and adults. However, its pathophysiology remains undefined. We evaluated our database for patterns in family history of clinical symptoms and associated disorders in these patients. MATERIALS AND METHODS:Patients with postura...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951120000165

    authors: Boris JR,Huang J,Shuey T,Bernadzikowski T

    更新日期:2020-03-01 00:00:00

  • Different haemodynamic patterns in head-up tilt test on 400 paediatric cases with unexplained syncope.

    abstract:OBJECTIVE:To assess haemodynamic patterns in head-up tilt testing on 400 paediatric cases with unexplained syncope. METHODS:Medical records of 520 children who underwent head-up tilt testing in the preceding year were retrospectively evaluated, and 400 children, 264 (66%) girls and 136 (34%) boys, aged 12.6±2.6 years ...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951114001176

    authors: Yozgat Y,Karadeniz C,Ozdemir R,Doksoz O,Kucuk M,Karaarslan U,Mese T,Unal N

    更新日期:2015-06-01 00:00:00

  • Appropriate use of a beta-blocker in paediatric coronary CT angiography.

    abstract:BACKGROUND:There is no standard dose or protocol for beta-blocker administration as preconditioning in children undergoing coronary CT angiography. METHODS:A total of 63 consecutive patients, with a mean age of 10.0±3.1 years, who underwent coronary CT angiography to assess possible coronary complications were enrolle...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S104795111800118X

    authors: Watanabe H,Kamiyama H,Kato M,Komori A,Abe Y,Ayusawa M

    更新日期:2018-10-01 00:00:00

  • Living the heart in three dimensions: applications of 3D printing in CHD.

    abstract::Advances in biomedical engineering have led to three-dimensional (3D)-printed models being used for a broad range of different applications. Teaching medical personnel, communicating with patients and relatives, planning complex heart surgery, or designing new techniques for repair of CHD via cardiac catheterisation a...

    journal_title:Cardiology in the young

    pub_type: 杂志文章,评审

    doi:10.1017/S1047951119000398

    authors: Forte MNV,Hussain T,Roest A,Gomez G,Jongbloed M,Simpson J,Pushparajah K,Byrne N,Valverde I

    更新日期:2019-06-01 00:00:00

  • A full-term healthy neonate with respiratory distress.

    abstract::Pneumopericardium, defined as air in the pericardial cavity, is a rare condition with potentially severe complications and mortality. In the neonatal period, pneumopericardium is associated with prematurity, very low birth weight, and assisted ventilation. We report the occurrence of spontaneous pneumopericardium in a...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951117002657

    authors: Nederlof I,Roest AAW,Starreveld JS

    更新日期:2018-03-01 00:00:00

  • The role of the cardiologist in the evaluation of dysautonomia.

    abstract::Dysfunction of the autonomic nervous system, or dysautonomia, is an uncommon disease. Postural orthostatic tachycardia syndrome is one of the several types of dysautonomia. Postural orthostatic tachycardia syndrome, also known as chronic orthostatic intolerance, is the most common but least severe of the dysautonomic ...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951110001198

    authors: Boris JR

    更新日期:2010-12-01 00:00:00

  • Tetralogy of Fallot: epidemiology meets real-world management: lessons from the Baltimore-Washington Infant Study.

    abstract::Decades ago, mass-scale epidemiologic studies were undertaken to accurately describe the prevalence of congenital heart disease and associated malformations, and to identify inheritance patterns, teratogenic influence and aetiologic underpinnings. Despite phenomenal breakthroughs in molecular diagnosis of congenital h...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951113001698

    authors: Nies M,Brenner JI

    更新日期:2013-12-01 00:00:00

  • Percutaneous pulmonary valve implantation with the Venus P-valve: clinical experience and early results.

    abstract:BACKGROUND:At present, the exclusion for percutaneous pulmonary valve implantation for free pulmonary regurgitation after tetralogy of Fallot repair includes an unfavourably large right ventricular outflow tract. OBJECTIVE:To report feasibility and early experience with a recently developed transcatheter heart valve, ...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951115001067

    authors: Promphan W,Prachasilchai P,Siripornpitak S,Qureshi SA,Layangool T

    更新日期:2016-04-01 00:00:00

  • Mentorship, learning curves, and balance.

    abstract::Professionals working in the arena of health care face a variety of challenges as their careers evolve and develop. In this review, we analyze the role of mentorship, learning curves, and balance in overcoming challenges that all such professionals are likely to encounter. These challenges can exist both in profession...

    journal_title:Cardiology in the young

    pub_type: 杂志文章,评审

    doi:10.1017/S1047951107001266

    authors: Cohen MS,Jacobs JP,Quintessenza JA,Chai PJ,Lindberg HL,Dickey J,Ungerleider RM

    更新日期:2007-09-01 00:00:00

  • The registry of anomalous aortic origin of the coronary artery of the Congenital Heart Surgeons' Society.

    abstract::The anomalous aortic origin of a coronary artery from the wrong sinus of Valsalva with interarterial, intramural, and/or intraconal course is a rare congenital anomaly that is associated with a high risk of sudden death in children. The Congenital Heart Surgeons' Society established the Registry of Anomalous Aortic Or...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951110001095

    authors: Brothers JA,Gaynor JW,Jacobs JP,Caldarone C,Jegatheeswaran A,Jacobs ML,Anomalous Coronary Artery Working Group.

    更新日期:2010-12-01 00:00:00

  • Use of Amplatzer Vascular Plugs for the treatment of combined extralobar and intralobar pulmonary sequestration in a 5-year-old child.

    abstract::Pulmonary sequestration is a rare congenital anomaly that can be asymptomatic or present with recurrent infections, respiratory symptoms, or rarely heart failure. Sequestration is classified as intralobar or extralobar on the basis of whether there is separation from normal lung tissue by its own visceral pleura. Clas...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S1047951116000901

    authors: Herbert CE,Reddy SR,Lemler MS

    更新日期:2016-10-01 00:00:00

  • The diagnostic evaluation of patients with complete transposition.

    abstract::SummaryThe vast majority of patients with complete transposition present during either the neonatal period or early infancy. Almost always the diagnosis and the categorization of associated lesions can be established by cross-sectional echocardiography. Doppler techniques usually provide enough information about flows...

    journal_title:Cardiology in the young

    pub_type: 杂志文章

    doi:10.1017/S104795110000007X

    authors: Rigby ML,Chan KY

    更新日期:1991-01-01 00:00:00