Tonight on the podcast , we bust another long term medical myth. This is Part 2 of the Ketamine Mythbusters series . This episode , we cover the haemodynamic effects of ketamine. Does it cause dangerous tachycardia and hypertension? How useful is it in the haemodynamically unstable patient?
Show note references:
- Ketamine: a review
- Haemodynamic response to induction of anaesthesia with ketamine/midazolam
- Pharmacokinetics and haemodynamics of ketamine in intensive care patients with brain or spinal cord injury
- Adverse cardiovascular effects of ketamine infusion in patients with catecholamine-dependent heart failure
- Ketamine for emergency anaesthesia at very high altitude(4243 m above sea-level)*
- Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting.
Now on to the AudioPodcast ( available here and on iTunes)
Right Click and Choose Save-as to Download the Podcast.
ketaminh
ntrueger
Yen Chow
Reblogged this on AmboFOAM and commented:
The PHARM podcast on ketamine part 2. This time it’s all about perfusion, good and bad.
Hi Minh
Enjoyed the podcast – short n sweet. Looking forward to the third instalment re: neuropsych issues with ketamine. Interesting case recently by colleague, details of which cannot share locally but may give you a call about. K worked well
Just thinking – no mention of benefits of ketamine as induction agent in asthma?
http://www.courts.sa.gov.au/CoronersFindings/Lists/Coroners%20Findings/Attachments/325/GORDON%20Sally%20Anne.pdf
Thoughts? it’s my ‘go to’ for the dreaded asthma intubation….
thanks Tim. yep appreciate the feedback. Medstar and Rural and Remote MH SA seem to be cautiously optimistic with their ketamine protocol.
as for asthma..actually not much evidence so might even be a mythbuster xtra episode ! Anecdotally yes it seems to work..sometimes!
C’mon and bust the myth for us!
Meanwhile, been trying to get hold of the ketamine protocol – rural MH not much help so far…
Hi minh,
Great podcast. On the myocardial depression area….what is the australian agent you would use for patients with poor inotropy? I had believed ketamine would have still been the best of a bad lot, and less of a negative inotrope then, say, propofol
listen to Scott’s excellent podcast here
http://www.intensivecarenetwork.com/index.php/icn-activities/smacc-2013/podcasts/623-smacc-weingart-on-tubing-the-shocked-patient
you can use ketamine but need to reduce the dose in a failing heart!
generally regardless of induction agent, it doesnt hurt to start noradrenaline or adrenaline infusion prior to RSI. you are probably going to need it post intubation during your maintenance sedation/analgesia!