Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16676
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dc.contributor.authorMiller, Matthew-
dc.contributor.authorKruit, Natalie-
dc.contributor.authorHeldreich, Charlotte-
dc.contributor.authorWare, Sandra-
dc.contributor.authorHabig, Karel-
dc.contributor.authorReid, Cliff-
dc.contributor.authorBurns, Brian-
dc.date.accessioned2017-06-15T07:36:36Z-
dc.date.available2017-06-15T07:36:36Z-
dc.date.issued2016-04-27-
dc.identifier.citationAnnals of Emergency Medicine 2016; 68(2): 181-188en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/16676-
dc.description.abstractSTUDY OBJECTIVE: Ketamine is considered a stable induction agent for rapid sequence induction; however, hypotension rates up to 24% are reported. The shock index (shock index=pulse rate/systolic blood pressure [SBP]) may identify patients at risk of adverse hemodynamic change. We investigate whether SBP and pulse rate response to ketamine induction differ when patients are classified as being at risk of shock by their shock index. METHODS: We conducted a prospective observational study of electronically collected vital sign data from patients undergoing rapid sequence induction with ketamine. Patients were grouped into low shock index (shock index <0.9) or high shock index (shock index ≥0.9) preinduction. Pulse rate and SBP were compared between 3 minutes preinduction and for 3 measurements postinduction (3-minute intervals) by repeated-measures ANOVA. Proportions of patients developing hypotension or hypertension are also reported. RESULTS: One hundred twelve patients were enrolled (81 low shock index, 31 high shock index). Low shock index patients had increased SBP after induction (16 mm Hg; 95% confidence interval [CI] 11 to 21 mm Hg), whereas high shock index patients did not (2 mm Hg; 95% CI -4 to 7 mm Hg). Pulse rate in low shock index patients increased after induction (20 beats/min; 95% CI 16 to 25 beats/min) and remained elevated, whereas in high shock index patients a difference occurred at the second postinduction measurement only (15 beats/min; 95% CI 11 to 18 beats/min). More high shock index patients became hypotensive (26%; 95% CI 12% to 45%) than low shock index ones (2%; 95% CI 0% to 9%), whereas more low shock index patients became hypertensive (40%; 95% CI 29% to 51%) than high shock index ones (13%; 95% CI 4% to 30%). CONCLUSION: After ketamine induction, high shock index patients exhibited blunted hypertensive responses and more frequent hypotension, whereas low shock index patients had sustained increases in pulse rate and SBP.en_US
dc.subjectAnalgesicsen_US
dc.subjectBlood Pressureen_US
dc.subjectHeart Rateen_US
dc.subjectKetamineen_US
dc.subjectShocken_US
dc.titleHemodynamic response after rapid sequence induction with ketamine in out-of-hospital patients at risk of shock as defined by the shock indexen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAnnals of Emergency Medicineen_US
dc.identifier.affiliationAeromedical and Retrieval Service, Ambulance Service, New South Wales, Sydney, Australiaen_US
dc.identifier.affiliationKent Surry Sussex Air Ambulance, Marden, Kent, United Kingdomen_US
dc.identifier.affiliationDepartment of Anaesthesia, Westmead Hospital, Sydney, New South Wales, Australiaen_US
dc.identifier.affiliationDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationSchool of Molecular Bioscience, University of Sydney, New South Wales, Australiaen_US
dc.identifier.affiliationSydney Medical School, Sydney University, New South Wales, Australiaen_US
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/27130803en_US
dc.identifier.doi10.1016/j.annemergmed.2016.03.041en_US
dc.type.contentTexten_US
dc.type.austinJournal Articleen_US
item.openairetypeJournal Article-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
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