@Article{chd.12662,
AUTHOR = {Rohit S. Loomba, Seth B. Gray, Saul Flores},
TITLE = {Hemodynamic effects of ketamine in children with congenital heart disease and/or pulmonary hypertension},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {5},
PAGES = {646--654},
URL = {http://www.techscience.com/schd/v13n5/39061},
ISSN = {3071-1738},
ABSTRACT = {Introduction: Ketamine is a drug often used for procedural sedation or as adjunct
agent for general sedation in children with congenital heart disease. In the clinical
realm, there is often confusion regarding the effects of ketamine on hemodynamics,
particularly pulmonary vascular resistance and systemic vascular resistance. We per‐
formed a meta‐analysis of studies investigating the effects of ketamine on
hemodynamics.
Methods: A systematic review was conducted to identify studies characterizing the
hemodynamic effects of ketamine in children with congenital heart disease. Studies
were assessed for quality and those of satisfactory quality with pre‐ and postketa‐
mine hemodynamics for each patient were included in the final analyses. Those not
limited to pediatric patients and those not limited to patients with congenital heart
disease were excluded from the final analyses.
Results: A total of 7 studies with 139 patients were included in the final analyses.
Pulmonary vascular resistance, systemic vascular resistance, mean pulmonary artery
pressure, mean systemic pressure, heart rate, pH, and arterial oxygen concentration
did not significantly change with administration of ketamine. Carbon dioxide concen‐
tration did increase significantly by a mean of 1.38 mm Hg with the administration of
ketamine.
Conclusion: Ketamine has minimal impact on hemodynamics in children with con‐
genital heart disease when used at usual clinical doses. Systemic vascular resistance
and pulmonary vascular resistance are not significantly altered. Blood gas values are
also only minimally affected by ketamine.},
DOI = {10.1111/chd.12662}
}