Hazards of Ketamine in Ischemic Heart Disease

Ao, Davies

doi:10.1213/00000539-198311000-00018

Cited by 1 publication

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“…However, ketamine without sympathetic stimulation depresses cardiac contractility in isolated animal hearts [21,22]. Ketamine also produces negative inotropic effects in patients with chronic catecholamine depletion or ischemic heart disease [23,24]. However, data are lacking on the effects of ketamine on blood pressure in critically ill patients [9].…”

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confidence: 99%

Effects of continuous ketamine infusion on hemodynamics and mortality in critically ill children

et al. 2019

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We investigated the hemodynamic and mortality effects of continuous ketamine infusion in critically ill pediatric patients. We conducted a retrospective cohort study in a tertiary pediatric intensive care unit (PICU). Patients who used continuous sedative from 2015 to 2017 for 24 hours or more were included. We compared blood pressure, heart and respiratory rates, vasogenic medications, and sedation and pain scores for 12 hours before and after initiation of continuous ketamine. The mortality rates for continuous ketamine and Non-ketamine groups were compared by multivariate logistic regression. A total of 240 patients used continuous sedation, and 82 used continuous ketamine. The median infusion rate of ketamine was 8.1 mcg/kg/min, and the median duration was 6 days. Heart rates (138 vs. 135 beat/minute, P = .033) and respiratory rates (31 vs. 25 respiration/minute, P = .001) decreased, but blood pressure (99.9 vs. 101.1 mm Hg, P = .124) and vasogenic medications did not change after ketamine infusion. Continuous ketamine was not a significant risk factor for mortality (hazard ratio 1.352, confidence interval 0.458–3.996). Continous ketamine could be used in PICU without hemodynamic instability. Further studies in randomized controlled design about the effects of continuous ketamine infusion on hemodynamic changes, sedation, and mortality are required.

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