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- W2287204071 abstract "The selection of ketamine as an anesthetic agent in patients with shock is still controversial. Hemodynamic effects of both stimulatory and depressive in nature have been reported. It is possible that metabolic acidosis secondary to the circulatory shock and/or arterial hypoxemia may potentiate the direct negative inotropic effect of ketamine and thereby producing circulatory depression in some of the poor risk patients. In the present investigation, we used a modified Langendorff preparation to study the influence of extracellular acidosis on the direct cardiac effects of ketamine. The changes of maximum left ventricular dP/dt ( LV dP/dtmax ) and heart rate ( HR) from baseline levels after exposure to ketamine 5, 25, 125 µg/ml in the normal pH ( 7.4 ) group averaged +7.1%, +0.8%, -42.6%, and -2.4%, -9.4%, -36.8%, respectively, and in the most severe acidosis ( pH 6.8 ), they were -10.9%, -19.3%, -49.8%, and -12.1%, -21.9%, -43.1%,respectively. At ketamine 5 and 25 µg/ml, a decrease in pH from 7.4 to 7.2 did not affect the ketamine effects significantly. When the pH was furher decreased to 7.0 and 6.8, the cardiac depression of ketamine became prominent. However, the degree of depression was not different between pH 7.0 and 6.8. At ketamine 125 µg/ml, the marked decreases in cardiac contractility and rate by this large dose did not appear to be significantly altered by the pH. The results indicate that low dose of ketamine directly increase cardiac contractility whereas high dose depresses the cardiac contractility and rate. Mild extracellular acidosis ( pH 7.2 ) does not significantly affect the ketamine effects. However, severe extracellular acidosis ( pH 7.0 and 6.8 ) does potentiate the direct negative inotropic and chronotropic effects of ketamine." @default.
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- W2287204071 date "1995-12-01" @default.
- W2287204071 modified "2023-09-27" @default.
- W2287204071 title "Influence of Extracellular Acidosis on the Direct Cardiac Effects of Ketamine" @default.
- W2287204071 doi "https://doi.org/10.6440/tzucmj.199512.0261" @default.
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