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Text
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<a href="http://doi.org/10.3171/2009.1.PEDS08319" target="_blank" rel="noreferrer">http://doi.org/10.3171/2009.1.PEDS08319</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Effectiveness of ketamine in decreasing intracranial pressure in children with intracranial hypertension
Publisher
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Journal Of Neurosurgery. Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Subject
The topic of the resource
Child; Humans; Male; Intensive Care Units; Prospective Studies; Israel; Respiratory Mechanics; adolescent; Preschool; infant; Blood Pressure/drug effects; Analgesics/administration & dosage/pharmacology; Brain/blood supply/drug effects; Cerebrovascular Circulation/drug effects; Intracranial Hypertension/drug therapy/prevention & control; Intracranial Pressure/drug effects; Ketamine/administration & dosage/pharmacology
Creator
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Bar-Joseph G; Guilburd Y; Tamir A; Guilburd JN
Description
An account of the resource
OBJECT: Deepening sedation is often needed in patients with intracranial hypertension. All widely used sedative and anesthetic agents (opioids, benzodiazepines, propofol, and barbiturates) decrease blood pressure and may therefore decrease cerebral perfusion pressure (CPP). Ketamine is a potent, safe, rapid-onset anesthetic agent that does not decrease blood pressure. However, ketamine's use in patients with traumatic brain injury and intracranial hypertension is precluded because it is widely stated that it increases intracranial pressure (ICP). Based on anecdotal clinical experience, the authors hypothesized that ketamine does not increase-but may rather decrease-ICP. METHODS: The authors conducted a prospective, controlled, clinical trial of data obtained in a pediatric intensive care unit of a regional trauma center. All patients were sedated and mechanically ventilated prior to inclusion in the study. Children with sustained, elevated ICP (> 18 mm Hg) resistant to first-tier therapies received a single ketamine dose (1-1.5 mg/kg) either to prevent further ICP increase during a potentially distressing intervention (Group 1) or as an additional measure to lower ICP (Group 2). Hemodynamic, ICP, and CPP values were recorded before ketamine administration, and repeated-measures analysis of variance was used to compare these values with those recorded every minute for 10 minutes following ketamine administration. RESULTS: The results of 82 ketamine administrations in 30 patients were analyzed. Overall, following ketamine administration, ICP decreased by 30% (from 25.8 +/- 8.4 to 18.0 +/- 8.5 mm Hg) (p 2 mm Hg during the distressing intervention in only 1 of 17 events. In Group 2, when ketamine was administered to lower persistent intracranial hypertension, ICP decreased by 33% (from 26.0 +/- 9.1 to 17.5 +/- 9.1 mm Hg) (p < 0.0001) following ketamine administration. CONCLUSIONS: In ventilation-treated patients with intracranial hypertension, ketamine effectively decreased ICP and prevented untoward ICP elevations during potentially distressing interventions, without lowering blood pressure and CPP. These results refute the notion that ketamine increases ICP. Ketamine is a safe and effective drug for patients with traumatic brain injury and intracranial hypertension, and it can possibly be used safely in trauma emergency situations.
2009
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.3171/2009.1.PEDS08319" target="_blank" rel="noreferrer">10.3171/2009.1.PEDS08319</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2009
Adolescent
Analgesics/administration & dosage/pharmacology
Backlog
Bar-Joseph G
Blood Pressure/drug effects
Brain/blood supply/drug effects
Cerebrovascular Circulation/drug effects
Child
Guilburd JN
Guilburd Y
Humans
Infant
Intensive Care Units
Intracranial Hypertension/drug therapy/prevention & control
Intracranial Pressure/drug effects
Israel
Journal Article
Journal Of Neurosurgery. Pediatrics
Ketamine/administration & dosage/pharmacology
Male
Preschool
Prospective Studies
Respiratory Mechanics
Tamir A
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.3171/2009.2.PEDS0944" target="_blank" rel="noreferrer">http://doi.org/10.3171/2009.2.PEDS0944</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Ketamine: still learning its secrets after 45 years
Publisher
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Journal Of Neurosurgery. Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Subject
The topic of the resource
Child; Humans; Analgesics/pharmacology; Blood Pressure/drug effects; Brain/blood supply/drug effects; Cerebrovascular Circulation/drug effects; Intracranial Pressure/drug effects; Ketamine/pharmacology
Creator
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Nemergut EC
Identifier
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<a href="http://doi.org/10.3171/2009.2.PEDS0944" target="_blank" rel="noreferrer">10.3171/2009.2.PEDS0944</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2009
2009
Analgesics/pharmacology
Backlog
Blood Pressure/drug effects
Brain/blood supply/drug effects
Cerebrovascular Circulation/drug effects
Child
Humans
Intracranial Pressure/drug effects
Journal Article
Journal Of Neurosurgery. Pediatrics
Ketamine/pharmacology
Nemergut EC