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Kevin Couloures, DO

  • Kevin Gottlieb Couloures

Especialidades médicas y/o especialidades quirúrgicas

Critical Care Medicine

Trabajo y educación

Educación

Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, CA, 06/01/2000

Últimos años de residencia

LAC+USC Pediatric Residency, Los Angeles, CA, 09/30/2004

Subespecialidad

AI Dupont Hospital for Children, Wilmington, DE, 06/30/2010

Cedars-Sinai Nephrology Fellowship Program, Los Angeles, CA, 11/01/2005

Certificado(s) de especialidad

Internal Medicine, American Board of Internal Medicine

Pediatric Critical Care Medicine, American Board of Pediatrics

Pediatrics, American Board of Pediatrics

Todo Publicaciones

Efficacy of Intravenous Ketamine in Adolescent Treatment-Resistant Depression: A Randomized Midazolam-Controlled Trial. The American journal of psychiatry Dwyer, J. B., Landeros-Weisenberger, A., Johnson, J. A., Londono Tobon, A., Flores, J. M., Nasir, M., Couloures, K., Sanacora, G., Bloch, M. H. 2021: appiajp202020010018

Abstract

OBJECTIVE: Adolescent depression is prevalent and is associated with significant morbidity and mortality. Although intravenous ketamine has shown efficacy in adult treatment-resistant depression, its efficacy in pediatric populations is unknown. The authors conducted an active-placebo-controlled study of ketamine's safety and efficacy in adolescents.METHODS: In this proof-of-concept randomized, double-blind, single-dose crossover clinical trial, 17 adolescents (ages 13-17) with a diagnosis of major depressive disorder received a single intravenous infusion of either ketamine (0.5 mg/kg over 40 minutes) or midazolam (0.045 mg/kg over 40 minutes), and the alternate compound 2 weeks later. All participants had previously tried at least one antidepressant medication and met the severity criterion of a score >40 on the Children's Depression Rating Scale-Revised. The primary outcome measure was score on the Montgomery-Asberg Depression Rating Scale (MADRS) 24 hours after treatment.RESULTS: A single ketamine infusion significantly reduced depressive symptoms 24 hours after infusion compared with midazolam (MADRS score: midazolam, mean=24.13, SD=12.08, 95% CI=18.21, 30.04; ketamine, mean=15.44, SD=10.07, 95% CI=10.51, 20.37; mean difference=-8.69, SD=15.08, 95% CI=-16.72, -0.65, df=15; effect size=0.78). In secondary analyses, the treatment gains associated with ketamine appeared to remain 14 days after treatment, the latest time point assessed, as measured by the MADRS (but not as measured by the Children's Depression Rating Scale-Revised). A significantly greater proportion of participants experienced a response to ketamine during the first 3 days following infusion as compared with midazolam (76% and 35%, respectively). Ketamine was associated with transient, self-limited dissociative symptoms that affected participant blinding, but there were no serious adverse events.CONCLUSIONS: In this first randomized placebo-controlled clinical trial of intravenous ketamine in adolescents with depression, the findings suggest that it is well tolerated acutely and has significant short-term (2-week) efficacy in reducing depressive symptoms compared with an active placebo.

View details for DOI 10.1176/appi.ajp.2020.20010018

View details for PubMedID 33653121

How Residents Learn During Emergent Situations May Be Different Than How We Were Taught. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Couloures, K. G. 2020; 21 (10): 9012

View details for DOI 10.1097/PCC.0000000000002466

View details for PubMedID 33009300

Can We Use Tissue Inhibitor Metalloproteinase-2 and Insulin-Like Growth Factor Binding Protein-7 Levels to Predict Acute Kidney Injury in Neonate and Infants Undergoing Cardiac Surgery? Not Yet. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Couloures, K. G., Marsenic, O. 2020; 21 (6): 59394

View details for DOI 10.1097/PCC.0000000000002282

View details for PubMedID 32483026