title: Ketamine-etomidate for children undergoing cardiac catheterization.
abstract: The purpose of this study was to determine the effects of combined low-dose ketamine and etomidate on hemodynamics during cardiac catheterization in children with congenital cardiac shunts. Sixty children undergoing routine diagnostic cardiac catheterization were included: 30 had a right-to-left shunt, and 30 had a left-to-right shunt. Both groups were given a single dose of etomidate 0.3 mg·kg(-1) with ketamine 1 mg·kg(-1). There were no hemodynamic changes in the group with a right-to-left shunt. In cases of left-to-right shunt, there were significant differences in heart rate, right atrial pressure, mean arterial pressure, mean pulmonary artery pressure, pulmonary artery wedge pressure, and systemic vascular resistance index. Decreases in pulmonary blood flow and pulmonary-systemic shunt ratio were also observed. Further studies are required with dose titration of this anesthetic combination in pediatric patients with congenital heart disease involving a left-to-right shunt.
authors.affiliation: Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India. madhurmed80@rediffmail.com
authors.forename: Madhur
authors.initials: M
authors.lastname: Malik
authors.forename: Vishwas
authors.initials: V
authors.lastname: Malik
authors.forename: Sandeep
authors.initials: S
authors.lastname: Chauhan
authors.forename: Naresh
authors.initials: N
authors.lastname: Dhawan
authors.forename: Usha
authors.initials: U
authors.lastname: Kiran
mesh_terms: D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005045:Etomidate / Q000008:administration & dosage*; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007194:India; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage*
chemical_list: D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D007649:Ketamine; D005045:Etomidate