Hemodynamic effects of ketamine in children undergoing cardiac catheterization.
Ketamine is used to supplement sedation during cardiac catheterization. We studied ketamine-induced circulatory changes in 28 acyanotic children (18 of whom had left-to-right shunts), aged 4-161 months (mean, 33 months). Oxygen consumption (VO2) was measured continuously. In the 18 patients with shunts, the pulmonary to systemic flow ratio fell slightly (2.3 +/- 1.1 to 1.8 +/- 0.4, p less than 0.05). In all patients, the ratio of pulmonary (PVR) to systemic vascular resistance (SVR) rose from 0.16 +/- 0.09 to 0.28 +/- 0.21, p less than 0.001. Ketamine increases VO2, heart rate, cardiac output, and pulmonary arterial pressure (PAP). The rise in PAP is more consistent than the rise in PVR; resistance changes were greatest in patients with elevated resting PVR (r = 0.54). Caution should be used in administering ketamine to selected subjects; moreover, ketamine can confuse interpretation of cardiac catheterization data, especially if VO2 is assumed and not measured.
Berman
W
W
Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque.
Fripp
R R
RR
Rubler
M
M
Alderete
L
L
D000293:Adolescent; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000494:pharmacology*
D007649:Ketamine