ArticleFrontiers in pediatrics2026
Efficacy and safety of intranasal dexmedetomidine vs. oral chloral hydrate sedation for transthoracic echocardiography in infants with congenital heart disease aged under 3 months: a retrospective study.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: The procedural sedation for young children, especially in infants under 3 months old, and those with congenital heart disease (CHD) is relatively challenging and risky. This study compares the efficacy and safety of intranasal dexmedetomidine and oral chloral hydrate for sedation in these special populations and identifies the risk factors that influencing sedation success. Methods: This retrospective study included infants with CHD aged under 3 months who underwent outpatient sedation for transthoracic echocardiography (TTE) from January 2023 to January 2024. Sedation was administered as either intranasal dexmedetomidine (Dex) 2 μg/kg or oral chloral hydrate (50 mg/kg). Failure to achieve adequate sedation with the initial dose was defined as initial sedation failure. Ultimate sedation failure was determined if TTE examination remained incomplete despite rescue interventions. Data including heart rate (HR), pulse oxygen saturation (SpO Results: A total of 383 patients were included in the final analysis. The initial sedation success rate and the overall success rate were higher in the Dex 2 μg/kg group than in the chloral hydrate group before and after PSM. The sedation onset time and the discharge time in the Dex 2 μg/kg group was significantly shorter than those in the chloral hydrate group. The decline of HR in the Dex 2 μg/kg group was greater than that in the chloral hydrate group both before and after PSM. No severe adverse reactions occurred. Children with low body weight and prolonged fasting time were independent risk factors that influencing sedation success rate. Conclusions: Compared with oral chloral hydrate, the use of intranasal dexmedetomidine of 2 μg/kg was related to a significantly higher success rate of sedation without increasing severe adverse events in infants with CHD aged under 3 months. Prolonged fasting time and low body weight may significantly affect sedation success.
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