Hemodynamic Effects of Bolus of Ketamine Versus Fentanyl in Patients With Septic Shock
Status:
Completed
Trial end date:
2023-12-15
Target enrollment:
Participant gender:
Summary
Ketamine is a commonly used drug for sedation and induction of anesthesia in patients with
shock and/or cardiac dysfunction. Ketamine is characterized by its cardiovascular stimulatory
effect due to increase release of endogenous catecholamines. On the other hand, laboratory
data on the isolated human myofibers suggest that ketamine had a direct myocardial depressive
effect; accordingly, many experts believe that ketamine might have a negative hemodynamic
effect in catecholamine depleted patients such as critically ill patients. In critically ill
patients, there are contradicting results for the effect of ketamine on the hemodynamic
profile and there is paucity of clinical data about the effect of ketamine on cardiac
contractility and cardiac output (CO). Cardiac output is the primary determinant of global
oxygen delivery to organs and maintaining stable CO in critically ill patients is at most
importance to avoid further organ damage in such patients.
Therefore, this study is designed to evaluate the effect a single bolus of ketamine on CO in
patients with septic shock in comparison to fentanyl bolus.