Role of ketamine in refractory status asthmaticus: A case report

Piyush Upadhyay
3.712 851

Abstract


Patients experiencing severe asthma exacerbations occasionally deteriorate to respiratory failure requiring endotracheal intubation and mechanical ventilation. Mechanical ventilation in this setting exposes the patients to substantial iatrogenic risk and should be avoided if at all possible. This case suggests that intravenous ketamine given in a dissociative dose may be an effective measure to avoid mechanical ventilation in pediatric patients with severe asthma exacerbations.

Keywords


Ketamine, Refractory status asthmaticus

Full Text:

E196


References


Corssen G, Gutierrez J, Reves JG, Huber FC Jr. Ketamine in the anesthetic management of asthmatic patients. Anesth Analg. 1972;51:588-96.

Gateau O, Bourgain JL, Gaudy JH, Benveniste J. Effects of ketamine on isolated human bronchial preparations. Br J Anaesth. 1989;63:692-5.

Betts EK, Parkin CE. Use of ketamine in an asthmatic child: a case report. Anesth Analg. 1971;50:420-1.

Petrillo TM, Fortenberry JD, Linzer JF, Simon HK. Emergency department use of ketamine in pediatric status asthmaticus. J Asthma. 2001;38:657-64.

Allen JY, Macias CG. The efficacy of ketamine in pediatric emergency department patients who present with acute severe asthma. Ann Emerg Med. 2005;46:43-50. Denmark TK, Crane HA, Brown L. Ketamine to avoid mechanical ventilation in severe pediatric asthma. J Emerg Med. 2006;30:163-6.

Rock MJ, Reyes de la Rocha S, L’Hommedieu CS, Truemper E. Use of ketamine in asthmatic children to treat respiratory failure refractory to conventional therapy. Crit Care Med. 1986;14:514-6.

Nehama J, Pass R, Bechtler-Karsch A, Steinberg C, Notterman DA. Continuous ketamine infusion for the treatment of refractory asthma in a mechanically ventilated infant: case report and review of the pediatric literature. Pediatr Emerg Care. 1996;12:294-7.

Youssef-Ahmed MZ, Silver P, Nimkoff L, Sagy M. Continuous infusion of ketamine in mechanically ventilated children with refractory bronchospasm. Intensive Care Med. 1996;22:972-6.