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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cardiovascular effects of intravenous administration of ketorolac tromethamine 10 and 90 mg were measured and compared with those of morphine sulfate 10 mg in 18 anesthetized patients after major vascular surgery. Morphine caused a significant reduction in mean arterial pressure, left cardiac work index, and left ventricular stroke work index. Stroke volume index, cardiac output, and pulmonary artery pressures decreased to a lesser extent. Ketorolac at either dose was not associated with any significant change in cardiac and hemodynamic parameters. The data suggest that even high doses of the drug may be safely administered in clinical situations where hypotension is disadvantageous or where reduction in afterload is not a specific therapeutic aim.
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PMID:Hemodynamic effects of two intravenous doses of ketorolac tromethamine compared with morphine. 208 8

Massive cutaneous burn combined with smoke inhalation causes high mortality in fire victims. Cyclo-oxygenase (COX) and inducible nitric oxide (NO) synthase (iNOS) have been shown to be up-regulated in burn injury. Ketorolac, a non-steroidal, anti-inflammatory agent (NSAID), inhibits prostaglandin and thromboxane synthesis through inhibition of COX. NSAIDs have been shown to down-regulate iNOS. Thus we hypothesized that treatment with ketorolac would attenuate burn/smoke-related cardiopulmonary derangements. We conducted a fully controlled long-term laboratory investigation in an Intensive Care Unit setting. Eighteen female sheep were surgically prepared for chronic study. After a recovery period of 5 days, a tracheotomy was performed under ketamine/halothane anaesthesia. Sheep were given a 40% total body surface third-degree burn and insufflated with cotton smoke (48 breaths, <40 degrees C). Sheep were divided into three groups: sham (not injured and not treated; n =6), control (injured, but not treated; n =6) and treated (injured and administered ketorolac 60 mg/day; n =6). The sham group had stable cardiopulmonary and systemic haemodynamics. Control animals showed depressed cardiopulmonary function, decreased pulmonary gas exchange, increased pulmonary microvascular leakage and decreased left ventricle stroke work index with elevated left atrial pressure. Systemic vascular leak in control animals was evidenced by robust haemoconcentration (haematocrit and fluid net balance). Treatment with ketorolac prevented all of these morbidities. Post-treatment with ketorolac also resulted in significant inhibition of elevated plasma nitrite/nitrate levels in control animals. These results suggest that ketorolac may ameliorate cardiopulmonary morbidity, at least in part, by inhibiting excessive NO.
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PMID:Ketorolac attenuates cardiopulmonary derangements in sheep with combined burn and smoke inhalation injury. 1292 81