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Utilizing the Modified T-Maze to Assess Functional Memory Outcomes After Cardiac Arrest
Published on: January 5, 2018
Cardiac arrest following ketamine administration for rapid sequence intubation
Elisabeth Dewhirst1, W Joshua Frazier, Marc Leder
1Department of Anesthesiology, Nationwide Children's Hospital and the Ohio State University, Columbus, Ohio, USA.
Abstract:
Given their relative hemodynamic stability, ketamine and etomidate are commonly chosen anesthetic agents for sedation during the endotracheal intubation of critically ill patients. As the use of etomidate has come into question particularly in patients with sepsis, due to its effect of adrenal suppression, there has been a shift in practice with more reliance on ketamine. However, as ketamine relies on a secondary sympathomimetic effect for its cardiovascular stability, cardiovascular and hemodynamic compromise may occur in patients who are catecholamine depleted. We present 2 critically ill patients who experienced cardiac arrest following the administration of ketamine for rapid sequence intubation (RSI). The literature regarding the use of etomidate and ketamine for RSI in critically ill patients is reviewed and options for sedation during endotracheal intubation in this population are discussed.
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