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Comparing the hemodynamic effects of ketamine versus fentanyl bolus in patients with septic shock: a randomized controlled trial.
Mostafa, Maha; Hasanin, Ahmed; Reda, Basant; Elsayad, Mohamed; Zayed, Marwa; Abdelfatah, Mohamed E.
Afiliación
  • Mostafa M; Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Hasanin A; Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt. ahmedmohamedhasanin@gmail.com.
  • Reda B; Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Elsayad M; Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Zayed M; Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Abdelfatah ME; Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Anesth ; 2024 Aug 18.
Article en En | MEDLINE | ID: mdl-39154316
ABSTRACT

BACKGROUND:

Ketamine and fentanyl are commonly used for sedation and induction of anesthesia in critically ill patients. This study aimed to compare the hemodynamic effects of ketamine versus fentanyl bolus in patients with septic shock.

METHODS:

This randomized controlled trial included mechanically ventilated adults with septic shock receiving sedation. Patients were randomized to receive either 1 mg/kg ketamine bolus or 1 mcg/kg fentanyl bolus. Cardiac output (CO), stroke volume (SV), heart rate (HR), and mean arterial pressure (MAP) were measured at the baseline, 3, 6, 10, and 15 min after the intervention. Delta CO was calculated as the change in CO at each time point in relation to baseline measurement. The primary outcome was delta CO 6 min after administration of the study drug. Other outcomes included CO, SV, HR, and MAP.

RESULTS:

Eighty-six patients were analyzed. The median (quartiles) delta CO 6 min after drug injection was 71(37, 116)% in the ketamine group versus - 31(- 43, - 12)% in the fentanyl group, P value < 0.001. The CO, SV, HR, and MAP increased in the ketamine group and decreased in the fentanyl group in relation to the baseline reading; and all were higher in the ketamine group than the fentanyl group.

CONCLUSION:

In patients with septic shock, ketamine bolus was associated with higher CO and SV compared to fentanyl bolus. CLINICAL TRIAL REGISTRATION Date of registration 24/07/2023. CLINICALTRIALS gov Identifier NCT05957302. URL https//clinicaltrials.gov/study/NCT05957302 .
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Egipto Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Egipto Pais de publicación: Japón