Ketamine is considered a valuable prehospital sedative in critically ill patients due to its unique pharmacological properties and clinical benefits. Studies have shown that ketamine is effective as an analgosedative in this population (Garber et al., 2019). It has a wide therapeutic index, making it a safe option for sedation, particularly when administered continuously (Groetzinger et al., 2018). While ketamine is cost-effective and widely available, further analysis is needed to assess its safety in specific clinical settings (Umunna et al., 2015). Ketamine's role as an adjunct sedative in critically ill patients has become popular due to its sedative and analgesic effects (Jaeger et al., 2020). The combination of analgesic and sedative properties, along with hemodynamic stability, makes ketamine an attractive option in critical care settings (Opdenakker et al., 2019).
Moreover, ketamine has shown promise in reducing opioid exposure in postoperative and mechanically ventilated patients in the ICU (Chan et al., 2022). Although propofol and midazolam are commonly used in the early stages of critical illness, ketamine is often reserved for later stages when acute issues have improved (Khatib et al., 2022). The use of ketamine as an adjunct sedative in acute respiratory distress syndrome, including cases related to COVID-19 pneumonia, has demonstrated positive impacts on patient outcomes (Garner et al., 2021). Additionally, ketamine's safety profile and its ability to provide sedation and analgesia make it a valuable option for managing critically ill patients (Knooihuizen et al., 2021).
In conclusion, various studies support the use of ketamine as the preferred prehospital sedative in critically ill patients. Its unique pharmacological properties, safety profile, and clinical benefits make it a valuable asset in managing sedation and analgesia in this patient population.
References:
- Chan, K., Burry, L., Tse, C., Wunsch, H., & Castro, C. (2022). Impact of ketamine on analgosedative consumption in critically ill patients: a systematic review and meta-analysis. Annals of Pharmacotherapy, 56(10), 1139-1158.
https://doi.org/10.1177/10600280211069617
- Garber, P., Droege, C., Carter, K., Harger, N., & Mueller, E. (2019). Continuous infusion ketamine for adjunctive analgosedation in mechanically ventilated, critically ill patients. Pharmacotherapy the Journal of Human Pharmacology and Drug Therapy, 39(3), 288-296.
https://doi.org/10.1002/phar.2223
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https://doi.org/10.1002/phar.2065
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https://doi.org/10.1177/0897190020925932
- Khatib, S., Roelofsz, D., Singh, S., Rao, A., Brinton, T., & Howell, G. (2022). Hemodynamic effects of ketamine infusion in the intensive care unit for maintenance sedation compared with propofol and midazolam: a retrospective cohort study. Ochsner Journal, 22(3), 225-229.
https://doi.org/10.31486/toj.22.0032
- Knooihuizen, S., Aday, A., & Lee, W. (2021). Ketamine‐induced sclerosing cholangitis (kisc) in a critically ill patient with covid‐19. Hepatology, 74(1), 519-521.
https://doi.org/10.1002/hep.31650
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https://doi.org/10.1097/mcc.0000000000000592
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