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Pharmacodynamics of chloral hydrate in former preterm infants

Karel Allegaert1, Hans Daniels, Gunnar Naulaers

  • 1Neonatal Intensive Care Unit, Department of Paediatrics, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. karel.allegaert@uz.kuleuven.ac.be

European Journal of Pediatrics
|March 31, 2005
PubMed

Insights

Chloral hydrate sedation in former preterm infants increased bradycardic events and decreased feeding. This highlights population-specific pharmacodynamics and kinetics requiring careful consideration in neonates.

Area of Science:

  • Neonatal pharmacology
  • Pediatric sedation

Background:

  • Former preterm infants require procedural sedation.
  • Chloral hydrate is commonly used for sedation in neonates.
  • Limited data exists on chloral hydrate pharmacodynamics in this population.

Purpose of the Study:

  • To evaluate the pharmacodynamics of chloral hydrate in former preterm infants.
  • To assess sedation, feeding, and cardiorespiratory events post-administration.
  • To identify potential risks associated with chloral hydrate use in this cohort.

Main Methods:

  • Prospective evaluation of 26 former preterm infants at term post-conception age.
  • Administration of oral chloral hydrate (30 mg/kg) for procedural sedation.
  • Monitoring of COMFORT sedation scale, feeding behavior, and cardiorespiratory events (bradycardia, apneas).
  • Statistical analysis using paired Wilcoxon, McNemar, Mann Whitney U, and Fischer's exact tests.

Main Results:

  • Significant increase in sedation (decrease in COMFORT scale) up to 12 hours.
  • Minor but significant decrease in oral intake (161 to 156 ml/kg/day).
  • Significant increase in bradycardic events (e.g., <60/min: 15 to 45 events) and their duration.
  • Infants with severe bradycardia had lower gestational age at birth.

Conclusions:

  • Chloral hydrate administration was associated with increased unintended side-effects in former preterm infants.
  • Findings suggest population-specific pharmacodynamics and kinetics of chloral hydrate in this group.
  • Further inclusion was stopped due to observed adverse events.
Abstract

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