Shock Index Predicts Hypotension in Patients Induced with Ketamine

An observational study confirms that ketamine can cause hypotension in catecholamine-depleted patients.

Ketamine causes catecholamine release, but when used for rapid sequence intubation (RSI), it generally does not have hemodynamically consequential effects. In a prospective observational study, investigators in Australia evaluated the hemodynamic effects of ketamine in patients undergoing RSI in the prehospital setting. They compared the effects between 81 patients with a pre-induction shock index (heart rate/systolic blood pressure) <0.9 (low shock index; LSI) and 31 patients with a pre-induction shock index ≥0.9 (high shock index; HSI). Vital signs were measured every 3 minutes up to 9 minutes after induction.

The total mean ketamine dose was 1.7 mg/kg in the HSI group and 2.0 mg/kg in the LSI group. Hypotension (systolic blood pressure <9…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Shock Index Predicts Hypotension in Patients Induced with Ketamine

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Reviewing Author