简介：MaleWistar7-day-oldratswereinjectedwith40mg/kgketamineintraperitoneally,followedbythreeadditionalinjectionsof20mg/kgketamineeachuponrestorationoftherightingreflex.Neonatalratsinjectedwithequivalentvolumesofsalineservedascontrols.Hippocampalsampleswerecollectedat1,7or14daysfollowingadministration.Electronmicroscopyshowedthatneuronalstructurechangednoticeablyfollowingketaminetreatment.Specifically,microtubularstructurebecameirregularanddisorganized.Quantitativerealtime-PCRrevealedthatphosphorylatedtaumRNAwasupregulatedafterketamine.Westernblotanalysisdemonstratedthatphosphorylatedtaulevelsatserine396initiallydecreasedat1dayafterketamineinjection,andthengraduallyreturnedtocontrolvalues.At14daysafterinjection,levelsofphosphorylatedtauwerehigherintheketaminegroupthaninthecontrolgroup.Tauproteinphosphorylatedatserine404significantlyincreasedafterketamineinjection,andthengraduallydecreasedwithtime.However,thelevelsoftauproteinatserine404weresignificantlygreaterintheketaminegroupthaninthecontrolgroupuntil14days.ThepresentresultsindicatethatketamineinducesanincreaseofphosphorylatedtaumRNAandexcessivephosphorylationoftauproteinatserine404,causingdisruptionofmicrotubulesintheneonatalrathippocampusandpotentiallyresultingindamagetohippocampalneurons.

简介：Background:Ketamineisappliedwidelyforsedationduringcardiaccatheterizationinspontaneouslybreathingchildrenwithcongenitalheartdisease(CHD).However,arareandunreportedrespiratorycomplication,transientandreversibleatelectasisoflungs(TRAL),wasidentified.Purpose:ThestudywasperformedtoinvestigateretrospectivelytheprevalenceandclinicalcharacteristicsofTRALafterketaminesedationinpediatriccardiaccatheterization.Methods:Fourthousandfourhundredandseventy-foursickchildrenweresedatedwithketamine,andpediatriccardiaccatheterizationwascarriedoutunderspontaneousbreathing.TRALwasdetectedin33children(17M/16F,agewas2.1±1.7years)byretrospectiveanalysis.Theclinicalandradiographiccharacteristicswererecordedbefore,duringandafterTRAL.Results:Inpediatriccardiaccatheterization,theprevalenceofTRALwas0.74%afterketaminesedation.TRALoccurredin23childrenwithcyanoticCHD,and10withacyanoticCHD.AllTRALshadcommonclinicalandradiographicfeatures:thediffuseopacityofbilaterallungsdevelopedrapidly(identifiedunderX-rayfluoroscopy),associatedwithdecreaseinlungvolume,andthenthedecreaseinSpO2(94.2±9.2%vs.59.4±2.2%,P<0.05),andheartrates(143.5±14.3bpmvs.58.3±9.7bpm,P<0.05)followedquickly.TRALwasrelievedbysupportiveoxygenin32children(23withfacemask,and9withendotrachealintubation),andthedurationofTRALwas1.6±0.5minutes.However,TRALcausedthedeathofonechild.Conclusions:TRALisarareandurgentrespiratorycomplicationafterketaminesedation,andthemechanismisunclear.RapidanddiffuseopacityofbilaterallungsistheearliestsignofTRALinpediatriccardiaccatheterization,andtheimmediatesupportiveoxygeniscrucial.

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