Ketamine Continuous Infusions in Critically Ill Infants and Children

The Annals of Pharmacotherapy
Charles L GoldingPeter N Johnson

Abstract

To review the role of ketamine continuous infusions (CINs) in critically ill children for sedation and analgesia, withdrawal, and bronchospasm. Relevant articles were identified using MEDLINE (1946 to December 2015), EMBASE (1988 to December 2015), International Pharmaceutical Abstracts (1970 to December 2015), and the Cochrane Library (1996 to December 2015) using the terms ketamine, children, and CIN. All English-language articles in humans identified from data sources were evaluated. Three studies and 8 case reports/series representing 74 patients were included. Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that blocks glutamate in the limbic system, resulting in sedation and analgesia. Additionally, it provides bronchodilation by increasing catecholamine transmission and stimulation of β2 receptors. The majority of reports evaluated ketamine for bronchospasm in children with status asthmaticus or bronchospasm refractory to conventional treatments. A total of 72 patients (97.3%) received a loading dose ranging from 0.2 to 2 mg/kg prior to CIN initiation. The CIN dosing range was 0.2 to 3.6 mg/kg/h. Children who received ketamine for sedation or opioid withdrawal received a lower dose than children initiated ...Continue Reading

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Citations

Aug 23, 2016·The Journal of Pharmacy and Pharmacology·Manuel A BaarslagDick Tibboel
May 26, 2017·World Journal of Clinical Pediatrics·Vijay SrinivasanSean P O'Neill
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May 18, 2021·Frontiers in Neuroscience·Ezio CarboniAntonello Novelli
Aug 17, 2021·Journal of Pediatric Intensive Care·Eszter MoorePeter N Johnson

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