Procedural moderate sedation with ketamine in pediatric critical care unit

Objective: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. Settings and Design: A retrospective stud...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Tarek R Hazwani, Hala Al Alem
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2017
Materias:	ketamine moderate sedation pediatric critical care Medicine R
Acceso en línea:	https://doaj.org/article/c0a99cd7a7dd42fcbee6623e107d9740
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c0a99cd7a7dd42fcbee6623e107d9740
record_format	dspace
spelling	oai:doaj.org-article:c0a99cd7a7dd42fcbee6623e107d97402021-12-02T16:24:58ZProcedural moderate sedation with ketamine in pediatric critical care unit2231-07702249-446410.4103/2231-0770.197507https://doaj.org/article/c0a99cd7a7dd42fcbee6623e107d97402017-01-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.197507https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Objective: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. Settings and Design: A retrospective study was conducted in the PICU. Materials and Methods: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria. Results: In this study, 246 moderate sedation sessions were included. 5.3% were in infant age, while 94.7% were children (1-14 years). Their gender distributed as 59.8% males and 40.2% females. The majority of them had hematology-oncology disease nature, i.e., 80.89% (n = 199). Lumbar puncture accounted for 65.3% (n = 160) of the producers; the rests were bone marrow aspiration 32.7%, endoscopy 8.2%, and colonoscopy 2.9%. Two doses of ketamine (1-1.5 mg/kg) to achieve moderate sedation during the procedure were given to 44.1% (n = 108) of the patients. One dose of midazolam was given to 77.2% (n = 190), while 1.22% (n = 3) of sessions of moderate sedation was done without any dose of midazolam. Adverse events including apnea, laryngeal spasm, hypotension, and recovery agitation were observed during moderate sedation sessions, and it has been noticed in four sessions, i.e., 1.6%, which were mild to moderate and managed conservatively. Conclusion: Moderate sedation in the PICU using ketamine and midazolam is generally safe with minimal side effects as moderate sedation sessions were conducted by pediatric intensivist in highly monitored and equipped environment.Tarek R HazwaniHala Al AlemThieme Medical and Scientific Publishers Pvt. Ltd.articleketaminemoderate sedationpediatric critical careMedicineRENAvicenna Journal of Medicine, Vol 07, Iss 01, Pp 7-11 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	ketamine moderate sedation pediatric critical care Medicine R
spellingShingle	ketamine moderate sedation pediatric critical care Medicine R Tarek R Hazwani Hala Al Alem Procedural moderate sedation with ketamine in pediatric critical care unit
description	Objective: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. Settings and Design: A retrospective study was conducted in the PICU. Materials and Methods: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria. Results: In this study, 246 moderate sedation sessions were included. 5.3% were in infant age, while 94.7% were children (1-14 years). Their gender distributed as 59.8% males and 40.2% females. The majority of them had hematology-oncology disease nature, i.e., 80.89% (n = 199). Lumbar puncture accounted for 65.3% (n = 160) of the producers; the rests were bone marrow aspiration 32.7%, endoscopy 8.2%, and colonoscopy 2.9%. Two doses of ketamine (1-1.5 mg/kg) to achieve moderate sedation during the procedure were given to 44.1% (n = 108) of the patients. One dose of midazolam was given to 77.2% (n = 190), while 1.22% (n = 3) of sessions of moderate sedation was done without any dose of midazolam. Adverse events including apnea, laryngeal spasm, hypotension, and recovery agitation were observed during moderate sedation sessions, and it has been noticed in four sessions, i.e., 1.6%, which were mild to moderate and managed conservatively. Conclusion: Moderate sedation in the PICU using ketamine and midazolam is generally safe with minimal side effects as moderate sedation sessions were conducted by pediatric intensivist in highly monitored and equipped environment.
format	article
author	Tarek R Hazwani Hala Al Alem
author_facet	Tarek R Hazwani Hala Al Alem
author_sort	Tarek R Hazwani
title	Procedural moderate sedation with ketamine in pediatric critical care unit
title_short	Procedural moderate sedation with ketamine in pediatric critical care unit
title_full	Procedural moderate sedation with ketamine in pediatric critical care unit
title_fullStr	Procedural moderate sedation with ketamine in pediatric critical care unit
title_full_unstemmed	Procedural moderate sedation with ketamine in pediatric critical care unit
title_sort	procedural moderate sedation with ketamine in pediatric critical care unit
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2017
url	https://doaj.org/article/c0a99cd7a7dd42fcbee6623e107d9740
work_keys_str_mv	AT tarekrhazwani proceduralmoderatesedationwithketamineinpediatriccriticalcareunit AT halaalalem proceduralmoderatesedationwithketamineinpediatriccriticalcareunit
_version_	1718384078748647424

Procedural moderate sedation with ketamine in pediatric critical care unit

Ejemplares similares