Impact of Low-Dose Ketamine Infusion on Intracranial Pressure and Hemodynamics in Septic Shock Patients.
Neurocritical care June 18, 2025 Essamedin M Negm, Hossam Tharwat Ali, Hanaa A Nofal et al. 4 citations
In 100 mechanically ventilated adults with septic shock but without acute brain injury, a low-dose continuous ketamine infusion (0.3 μg/kg/hr) was added to standard sedation. Only one of three noninvasive intracranial pressure (ICP) measures—ICP derived from diastolic flow velocity—showed a statistically significant but very small increase over 24 hours. Cerebral perfusion pressure and vital signs (heart rate, blood pressure, respiratory rate) remained stable. Doses of midazolam, fentanyl, and norepinephrine decreased substantially, especially in the first 12 hours. The findings suggest low-dose ketamine can be used adjunctively without raising ICP or destabilizing hemodynamics, while reducing overall medication burden.