The Probable Effect of Ketamine on Ceasing from the Mechanical Ventilation
Journal Title: Çocuk Acil ve Çocuk Yoğun Bakım Dergisi - Year 2016, Vol 3, Issue 2
Abstract
Non-ketotic hyperglycinemia (NCH) is a life-threatening autosomal recessive hereditary metabolic disease characterized by accumulation of a large amount of glycine in serum and cerebrospinal fluids. A 3-month-old girl was referred to our intensive care unit due to poor feeding, respiratory failure and refractory seizures. Physical examination revealed poor general condition, hypotony, lethargia and quite shallow breathing. Her complete blood count, peripheral blood smear, liver and kidney function tests, serum electrolytes, blood gases, C-reactive protein, procalcitonin, ammonia and lactate levels were within the normal ranges. Her tandem mass and urine organic acid analyses were also normal. Blood and cerebrospinal fluid cultures were sterile. A suppression-burst pattern (modified hypsarrhythmia) was detected in electroencephalographic evaluation. The cerebrospinal fluid glycine level was elevated more than 10 folds and the cerebrospinal fluid glycine/plasma glycine ratio was 0.15. According to these laboratory findings, she was diagnosed with NCH and dextromethorphan and sodium benzoate therapies were initiated. Ventilatory support was provided due to respiratory failure. She was followed by the Synchronized intermittent mandatory ventilation + pressure support mode, and ketamine (2 mg/kg, iv) therapy was initiated. At the 7th day of this therapy, there was no need for mechanical ventilation anymore. This case gives us an idea about the efficiency of ketamine in ceasing NCH patients from mechanical ventilation at early stages of disease.
Authors and Affiliations
Mehmet Davutoğlu, Zehra Kılıç, Tahir Dalkıran, Yasemin Çoban, Nihal Karabel, Ahmet Çetinkaya
Keywords
Related Articles
- EP ID EP227109
- DOI 10.4274/cayd.29392
- Views 100
- Downloads 0
Cardiogenic Shock and Lung Injury as a Complication of Defibrillation
Local burns, embolism, and arrhythmia are the most common side effects observed after electrical shock treatments. However, systolic function may be rarely affected and pulmonary edema may develop. The cases of pulmonary...
B-Type Natriuretic Peptide in Bronchiolitis: Its Relationship with Left Ventricular Systolic Functions and Prognosis
Introduction: We have limited information about the clinical importance of plasma B-type natriuretic peptide (BNP) level and its prognostic value in children with bronchiolitis. In this study, we aimed to determine basal...
Analysis of Patients Presenting to a Pediatric Emergency Department with Acute Limping
Introduction: Limping is a common presenting complaint to a pediatric emergency department among children. The differential diagnosis of acute limp includes transient synovitis, trauma, infections, neoplasia, and congeni...
A Case of Fatal Malignant Hyperthermia During Pes Equinovarus Surgery in a Child
Malignant hyperthermia (MH) is a genetic syndrome characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity, often triggered by depolarizing muscle relaxants such as volatile anesthetics and/or succinylch...
Comparative Evaluation of the Development of the Children Living with Their Mother in the Prison
Objectives: The study was a descriptive study which designed to compare the development of children who were living with their parents and who were living with their mothers in prison. Materials and Methods: A total of 8...