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 ( {Mathematical expression}) 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<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<0.001. Ketamine increases {Mathematical expression}, 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 {Mathematical expression} is assumed and not measured. © 1990 Springer-Verlag New York Inc.