Document Detail

Ketamine anesthesia for pericardial window in a patient with pericardial tamponade and severe COPD.
MedLine Citation:
PMID:  11861347     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe the use and concerns of ketamine anesthesia for pericardial window in a patient with pericardial tamponade and severe chronic obstructive pulmonary disease (COPD) with CO(2) retention. CLINICAL FEATURES: A 73-yr-old woman with long-standing COPD and cor pulmonale admitted with pericardial effusion and tamponade had surgery for a pericardial window receiving a total of ketamine 450 mg iv. Arterial pCO(2) increased from 71.8 mmHg preoperatively to 96 mmHg intraoperatively postdrainage of 1000 mL of effusion. Hemodynamic stability and SpO(2) >93% were maintained. Intubation was avoided and concerns of increased pulmonary vascular resistance and potential for right ventricular failure in an already compromised right ventricle were not observed clinically. CONCLUSION: In this patient with pericardial tamponade, COPD and CO(2) retention, the advantages of ketamine included maintaining spontaneous ventilation, avoiding institution and weaning of mechanical ventilation, bronchodilation and relative preservation of the CO(2) response curve. Deleterious effects on right ventricular afterload were not observed.
Tim Aye; Brian Milne
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  49     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-02-25     Completed Date:  2002-06-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  283-6     Citation Subset:  IM    
Department of Anesthesiology, Queen's University, Kingston, Ontario, Canada.
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MeSH Terms
Anesthesia / methods*
Carbon Dioxide / blood
Cardiac Tamponade / surgery*
Ketamine / pharmacology*
Pericardial Window Techniques*
Pulmonary Disease, Chronic Obstructive / physiopathology*
Vascular Resistance / drug effects
Reg. No./Substance:
124-38-9/Carbon Dioxide; 6740-88-1/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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