Impact of Prolonged Continuous Ketamine Infusions in Critically Ill Children: A Prospective Cohort Study.
Paediatric drugs September 1, 2024 Paulo Sérgio Lucas da Silva, Emerson Yukio Kubo, Rafael da Motta Ramos Siqueira et al. 4 citations
In mechanically ventilated children in the pediatric intensive care unit, continuous ketamine infusion for more than 24 hours was associated with a higher rate of adverse events, particularly delirium. Among 269 patients, delirium occurred in 22% of those receiving ketamine versus 7.6% of those who did not. Other adverse events included hypertension, hypersecretion, tachycardia, and nystagmus. Patients spent a greater proportion of time at their target sedation level after ketamine was started (84% versus 76% before initiation). The ketamine group also had longer durations of mechanical ventilation and longer stays in the PICU and hospital. The authors suggest that high-quality studies are needed before ketamine can be broadly recommended for sedation in this setting.