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


Autoři: Sojin Park aff001;  Ah Young Choi aff002;  Esther Park aff002;  Hyo Jung Park aff001;  Jaehyun Lee aff001;  Hukyoung Lee aff001;  JeongMee Kim aff001;  Joongbum Cho aff002
Působiště autorů: Department of Pharmaceutical Services, Samsung Medical Center, Seoul, Republic of Korea aff001;  Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224035

Souhrn

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.

Klíčová slova:

Blood pressure – Death rates – Heart rate – Hemodynamics – Hospitals – Intensive care units – Sedatives – Sedation


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 10