Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34383
Title: Efficacy and safety of ketamine in mechanically ventilated intensive care unit patients: a scoping review.
Austin Authors: Casamento, Andrew ;Niccol, Thomas
Affiliation: Intensive Care Unit, Northern Hospital, Melbourne, VIC, Australia.;Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia.
Intensive Care
Issue Date: 7-Mar-2022
Date: 2023
Publication information: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine 2022-03-07; 24(1)
Abstract: Objectives: Mechanically ventilated patients account for about one-third of all admissions to the intensive care unit (ICU). Ketamine has been conditionally recommended to aid with analgesia in such patients, with low quality of evidence available to support this recommendation. We aimed to perform a narrative scoping review of the current knowledge of the use of ketamine, with a specific focus on mechanically ventilated ICU patients. Methods: We searched MEDLINE and EMBASE for relevant articles. Bibliographies of retrieved articles were examined for references of potential relevance. We included studies that described the use of ketamine for postoperative and emergency department management of pain and in the critically unwell, mechanically ventilated population. Results: There are few randomised controlled trials evaluating ketamine's utility in the ICU. The evidence is predominantly retrospective and observational in nature and the results are heterogeneous. Available evidence is summarised in a descriptive manner, with a division made between high dose and low dose ketamine. Ketamine's pharmacology and use as an analgesic agent outside of the ICU is briefly discussed, followed by evidence for use in the ICU setting, with particular emphasis on analgesia, sedation and intubation. Finally, data on adverse effects including delirium, coma, haemodynamic adverse effects, raised intracranial pressure, hypersalivation and laryngospasm are presented. Conclusions: Ketamine is used in mechanically ventilated ICU patients with several potentially positive clinical effects. However, it has a significant side effect profile, which may limit its use in these patients. The role of low dose ketamine infusion in mechanically ventilated ICU patients is not well studied and requires investigation in high quality, prospective randomised trials.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34383
DOI: 10.51893/2022.1.OA9
ORCID: 
Journal: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
Start page: 71
End page: 82
PubMed URL: 38046843
Type: Journal Article
Appears in Collections:Journal articles

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