• Journal of critical care · Oct 2016

    Review

    Ketamine for analgosedation in critically ill patients.

    • Brian L Erstad and Asad E Patanwala.
    • Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, 1295 N Martin Ave, PO Box 210202, Tucson, AZ, USA.
    • J Crit Care. 2016 Oct 1; 35: 145-9.

    PurposeThe purpose of this narrative review is to provide practical and useful guidance for clinicians considering the use of intravenous ketamine for its analgosedative properties in adult, critically ill patients.MethodsMEDLINE was searched from inception until January 2016. Articles related to the pharmacological properties of ketamine were retrieved. Information pertaining to pharmacology, pharmacokinetics, dosing regimens, adverse effects, and outcomes was obtained from relevant studies.ResultsAlthough the primary mechanism for ketamine's pharmacological effects is N-methyl-d-aspartate blockade, there are several potential mechanisms of action. It has a very large volume of distribution due to its lipophilicity, which can lead to drug accumulation with sustained infusions. Ketamine has several advantages compared with conventional sedatives such as preserving pharyngeal and laryngeal protective reflexes, lowering airway resistance, increasing lung compliance, and being less likely to produce respiratory depression. It causes sympathetic stimulation, which is also unlike other sedatives and analgesics. There are psychotomimetic effects, which are a concern in terms of delirium. Dosing and monitoring recommendations are provided.ConclusionsKetamine has a unique pharmacological profile compared with more traditional agents such as opioids, which makes it an appealing alternative agent for analgosedation in the intensive care unit setting.Copyright © 2016 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…