Remimazolam for Procedural Sedation During Computed Tomography Angiography in a Patient With Poor Myocardial Performance Due to Cardiomyopathy.

Given their cognitive and developmental status, sedation is frequently required for procedural imaging in infants and children. Although generally free of adverse effects, the agents used for procedural sedation may impact airway, hemodynamic, and respiratory function, especially in the presence of comorbid cardiac involvement. We present the use of the novel benzodiazepine, remimazolam, administered by continuous infusion and supplemented with intermittent bolus doses of ketamine to provide sedation during computed tomography angiography in a 16-month-old girl, who presented with myocardial dysfunction related to a primary cardiomyopathy. Previous reports of remimazolam administration to patients with underlying comorbid cardiac disease are reviewed, and its applications in this scenario are discussed.