keyword
https://read.qxmd.com/read/38505599/a-case-of-hepatotoxicity-induced-by-therapeutic-ketamine-use-for-sedation
#1
Noah Yoo, Sarun Thomas, Michael Bender, Xian Jie Cindy Cheng
Ketamine, initially developed as an anesthetic, has shown versatility in medical applications, including pain management, treatment-resistant depression, and sedation in the intensive care unit (ICU). While generally well-tolerated, long-term use at high doses raises concerns about potential toxicities, particularly in the liver. We present a case of a 27-year-old female with a complex medical history who received ketamine infusion for ICU sedation and experienced a sudden rise in liver function tests (LFTs), indicating possible ketamine-induced liver injury (KILI)...
2024: Case Reports in Critical Care
https://read.qxmd.com/read/38490692/postoperative-pain-and-pain-management-following-selective-dorsal-rhizotomy
#2
JOURNAL ARTICLE
Isabel G Adams, Ramanie Jayaweera, Jennifer Lewis, Nadia Badawi, Mohamed E Abdel-Latif, Simon Paget
BACKGROUND: Selective dorsal rhizotomy (SDR) is a neurosurgical procedure that reduces lower limb spasticity, performed in some children with spastic diplegic cerebral palsy. Effective pain management after SDR is essential for early rehabilitation. This study aimed to describe the anaesthetic and early pain management, pain and adverse events in children following SDR. METHODS: This was a retrospective cohort study. Participants were all children who underwent SDR at a single Australian tertiary hospital between 2010 and 2020...
March 15, 2024: BMJ Paediatrics Open
https://read.qxmd.com/read/38283259/ketamine-for-primary-analgosedation-in-critically-ill-surgery-and-trauma-patients-requiring-mechanical-ventilation
#3
JOURNAL ARTICLE
Bradley J Peters, Kirstin J Kooda, Caitlin S Brown, Todd M Miles, Corrie A Kangas, Kristin C Mara, Mariela Rivera, Lee P Skrupky
OBJECTIVES: Evaluate effectiveness and safety outcomes associated with the use of ketamine for primary analgosedation in the surgical/trauma ICU setting. DESIGN: Retrospective cohort study. SETTING: Academic medical center in Minnesota. PATIENTS: Patients admitted to the surgical ICU between 2015 and 2019 requiring mechanical ventilation and meeting one of three definitions for ketamine primary analgosedation were included: 1) no concomitant opioid infusion, 2) ketamine monotherapy for greater than or equal to 6 hours with subsequent opioid infusion, or 3) ketamine initiated concomitantly or within 4 hours of opioid and total opioid duration less than 4 hours...
February 2024: Critical care explorations
https://read.qxmd.com/read/38222873/prevalence-of-delirium-after-abdominal-surgery-and-association-with-ketamine-a-retrospective-propensity-matched-cohort-study
#4
JOURNAL ARTICLE
Hina Faisal, Fatima Qamar, En Shuo Hsu, Jiaqiong Xu, Eugene C Lai, Stephen T Wong, Faisal N Masud
IMPORTANCE: Delirium is a common postoperative complication for older patients in the ICU. Ketamine, used primarily as an analgesic, has been thought to prevent delirium. OBJECTIVE: Determine the prevalence and association of delirium with low-dose ketamine use in ICU patients after abdominal surgery. DESIGN: Single-center, retrospective, propensity-matched cohort study. SETTING: Eight hospital academic medical center...
January 2024: Critical care explorations
https://read.qxmd.com/read/38117319/status-epilepticus-in-the-icu
#5
REVIEW
Andrea O Rossetti, Jan Claassen, Nicolas Gaspard
Status epilepticus (SE) is a common medical emergency associated with significant morbidity and mortality. Management that follows published guidelines is best suited to improve outcomes, with the most severe cases frequently being managed in the intensive care unit (ICU). Diagnosis of convulsive SE can be made without electroencephalography (EEG), but EEG is required to reliably diagnose nonconvulsive SE. Rapidly narrowing down underlying causes for SE is crucial, as this may guide additional management steps...
December 20, 2023: Intensive Care Medicine
https://read.qxmd.com/read/38006606/observational-study-of-the-effect-of-ketamine-infusions-on-sedation-depth-inflammation-and-clinical-outcomes-in-mechanically-ventilated-patients-with-sars-cov-2
#6
JOURNAL ARTICLE
David Wyler, Marc C Torjman, Ron Leong, Michael Baram, William Denk, Sara C Long, Richard J Gawel, Eugene R Viscusi, Irving W Wainer, Eric S Schwenk
Severely ill patients with COVID-19 are challenging to sedate and often require high-dose sedation and analgesic regimens. Ketamine can be an effective adjunct to facilitate sedation of critically ill patients but its effects on sedation level and inflammation in COVID-19 patients have not been studied. This retrospective, observational cohort study evaluated the effect of ketamine infusions on inflammatory biomarkers and clinical outcomes in mechanically ventilated patients with SARS-CoV-2 infection. A total of 186 patients were identified (47 received ketamine, 139 did not)...
November 25, 2023: Anaesthesia and Intensive Care
https://read.qxmd.com/read/37937877/ketamine-for-traumatic-assault-induced-depression-a-case-report
#7
JOURNAL ARTICLE
Caitlyn B Coffelt, Kyle Gibson, Jason VanLandingham
BACKGROUND: This case report describes the use of ketamine as a rapid, effective treatment of depression in a 68-year-old female patient with no significant medical history of psychiatric disorders. Patients who experience intentional or unintentional traumas are at an increased risk for developing depression or posttraumatic stress disorder, and emerging evidence has supported the use of ketamine as an alternative treatment of depression. CASE PRESENTATION: This is the case of a 68-year-old female patient who was assaulted, resulting in multiple stab wounds to both hands and the right upper quadrant...
November 2023: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://read.qxmd.com/read/37884773/ketamine-sedation-in-the-intensive-care-unit-a-survey-of-canadian-intensivists
#8
JOURNAL ARTICLE
Sameer Sharif, Laveena Munshi, Lisa Burry, Sangeeta Mehta, Sara Gray, Dipayan Chaudhuri, Mark Duffett, Reed A Siemieniuk, Bram Rochwerg
PURPOSE: We sought to understand the beliefs and practices of Canadian intensivists regarding their use of ketamine as a sedative in critically ill patients and to gauge their interest in a randomized controlled trial (RCT) examining its use in the intensive care unit (ICU). METHODS: We designed and validated an electronic self-administered survey examining the use of ketamine as a sedative infusion for ICU patients. We surveyed 400 physician members of the Canadian Critical Care Society (CCCS) via email between February and April 2022 and sent three reminders at two-week intervals...
October 26, 2023: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/37480556/efficacy-of-continuous-infusion-ketamine-for-analgosedation-in-the-medical-intensive-care-unit-a-propensity-weighted-analysis
#9
JOURNAL ARTICLE
BrookeAnne Magrum, Jessica L Elefritz, Greg Eisinger, Eric McLaughlin, Bruce Doepker
BACKGROUND: Few randomized controlled trials have evaluated the use of ketamine vs opiate-based analgosedation. METHODS: A retrospective cohort analysis of 169 mechanically ventilated patients admitted to the medical intensive care unit (MICU) at an academic medical center was conducted to evaluate efficacy of ketamine vs opiate-based analgosedation by comparing the percentage of time within target sedation range. The primary outcome was percentage of time within target sedation range (RASS -1 to +1) within first 72 hours of primary sedation initiation...
July 22, 2023: Journal of Pharmacy Practice
https://read.qxmd.com/read/37373687/perioperative-management-of-patients-undergoing-total-pancreatectomy-with-without-islet-cell-autotransplantation-a-single-center-experience
#10
JOURNAL ARTICLE
Trista D Reid, Supradeep S Madduri, Chris B Agala, Chengyu Weng, Sasha McEwan, Chirag S Desai
Total pancreatectomy (TP) and islet cell autotransplantation (IAT) are complex operations that require intensive postoperative monitoring with standardized protocols. There are few studies detailing immediate perioperative management. The purpose of this study was to describe the perioperative management of post-pancreatectomy patients in the first week following surgery to guide clinicians in addressing salient points from different organ systems. This is a retrospective cohort review of prospectively collected data from September 2017 to September 2022 at a single institution, including patients 16 years and older who underwent TP or TPIAT for chronic pancreatitis...
June 12, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37312629/the-use-of-ketamine-infusion-to-dramatically-reduce-opioid-requirements-in-a-patient-whose-high-dose-intrathecal-opioid-pump-was-inadvertently-cut-during-surgery
#11
William M McDonald, Michael M Wilkinson, Ankush Jain, Steven P Cohen
BACKGROUND: Chronic opioid therapy may lead to high level tolerance development, hyperalgesia, and central sensitization, which further complicates long-term therapeutic management of chronic pain patients. In this case, we encounter a patient who was receiving over 15,000 morphine milligram equivalents through their intrathecal pain pump. Unfortunately, the intrathecal pump was inadvertently cut during a spinal surgery. It was deemed unsafe to delivery IV equivalent opioid therapy in this case; instead, the patient was admitted to the ICU and given a four-day ketamine infusion...
June 13, 2023: Pain Practice: the Official Journal of World Institute of Pain
https://read.qxmd.com/read/37300529/predicting-favorable-response-to-intravenous-morphine-in-pediatric-critically-ill-cardiac-patients
#12
JOURNAL ARTICLE
Francesca Sperotto, Siva Emani, Lin Zhu, Marlòn Delgado, Mauricio Santillana, John N Kheir
INTRODUCTION: Analgesia and sedation are integral to the care of critically ill children. However, the choice and dose of the analgesic or sedative drug is often empiric, and models predicting favorable responses are lacking. We aimed to compute models to predict a patient's response to intravenous morphine. METHODS: We retrospectively analyzed data from consecutive patients admitted to the Cardiac Intensive Care Unit (January 2011-January 2020) who received at least one intravenous bolus of morphine...
July 2023: Pharmacotherapy
https://read.qxmd.com/read/37181899/the-therapeutic-use-and-efficacy-of-ketamine-in-alcohol-use-disorder-and-alcohol-withdrawal-syndrome-a-scoping-review
#13
REVIEW
Charlotte E Goldfine, Jeremiah J Tom, Dana D Im, Benjamin Yudkoff, Amit Anand, Joseph J Taylor, Peter R Chai, Joji Suzuki
INTRODUCTION: Alcohol use disorder (AUD) is the most prevalent substance use disorder (SUD) globally. In 2019, AUD affected 14.5 million Americans and contributed to 95,000 deaths, with an annual cost exceeding 250 billion dollars. Current treatment options for AUD have moderate therapeutic effects and high relapse rates. Recent investigations have demonstrated the potential efficacy of intravenous ketamine infusions to increase alcohol abstinence and may be a safe adjunct to the existing alcohol withdrawal syndrome (AWS) management strategies...
2023: Frontiers in Psychiatry
https://read.qxmd.com/read/37061729/pediatric-fulminant-malignant-hyperthermia-with-severe-electroencephalographic-abnormality-and-brain-damage-a-case-report
#14
JOURNAL ARTICLE
Sakura Minami, Azusa Ikeda, Kaori Yamada, Aya Kajihama, Hiroyuki Shimizu, Hiroyuki Nagafuchi
BACKGROUND: Malignant hyperthermia is an extremely dangerous condition that can occur with exposure to volatile inhalant anesthetics and depolarizing muscle relaxants, and that requires immediate intervention. Neurological complications have rarely been reported, with no reports of electroencephalographic abnormalities or encephalopathy. Here, we report a case of severe electroencephalographic abnormality in the acute phase of malignant hyperthermia that eventually led to diffuse cerebral cortical damage...
April 16, 2023: Journal of Medical Case Reports
https://read.qxmd.com/read/37014033/non-opioid-analgesics-for-procedural-pain-in-neonates
#15
REVIEW
Emma Persad, Ana Beatriz Pizarro, Matteo Bruschettini
BACKGROUND: Neonates are an extremely vulnerable patient population, with 6% to 9% admitted to the neonatal intensive care unit (NICU) following birth. Neonates admitted to the NICU will undergo multiple painful procedures per day throughout their stay. There is increasing evidence that frequent and repetitive exposure to painful stimuli is associated with poorer outcomes later in life. To date, a wide variety of pain control mechanisms have been developed and implemented to address procedural pain in neonates...
April 4, 2023: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/37003853/single-center-retrospective-comparison-of-opioid-based-and-multimodal-analgesic-regimens-in-adult-cardiac-surgery
#16
JOURNAL ARTICLE
Alyssa Eisenbraun, Darrell Schroeder, Hartzell V Schaff, Erin Martin, Erica D Wittwer
OBJECTIVES: To compare the outcomes of 2 multimodal analgesic regimens with an opioid-based one. DESIGN: A 2-stage, retrospective study. SETTING: A large tertiary-care facility. PARTICIPANTS: Adult cardiac surgical patients. INTERVENTIONS: Patients received one of three regimens: opioid-only or 2 multimodal regimens. The opioid regimen included intraoperative fentanyl and patient-controlled analgesia pumps...
March 10, 2023: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/36925340/prospective-observational-study-on-the-use-of-continuous-intravenous-ketamine-and-propofol-infusion-for-prolonged-sedation-in-critical-care
#17
JOURNAL ARTICLE
Laura Torres Soblechero, Doris Elena Ocampo Benegas, Gema Manrique Martín, Laura Butragueño Laiseca, Andrea María Leal Barceló, Alejandro Parreño Marchante, Jesús López-Herce Cid, Santiago Mencía Bartolome
INTRODUCTION: Analgesia and sedation are a priority in paediatric intensive care. The combination of ketamine and propofol is a possible option in patients requiring prolonged or difficult sedation and to reduce the use of benzodiazepines and opiates. The aim of this study was to assess the efficacy and safety of combination ketamine and propofol in continuous infusion for prolonged analgesia/sedation in the paediatric intensive care setting. PATIENTS AND METHODS: Prospective, observational single-group cohort study in patients aged 1 month to 16 years admitted to the paediatric intensive care unit in 2016-2018 that received ketamine and propofol in continuous infusion for analgesia and sedation...
March 14, 2023: Anales de pediatría
https://read.qxmd.com/read/36792542/ketamine-as-advanced-second-line-treatment-in-benzodiazepine-refractory-convulsive-status-epilepticus-in-children
#18
REVIEW
Silvia Buratti, Emanuele Giacheri, Antonella Palmieri, Jessica Tibaldi, Giacomo Brisca, Antonella Riva, Pasquale Striano, Maria Margherita Mancardi, Lino Nobili, Andrea Moscatelli
Status epilepticus (SE) is one of the most common neurological emergencies in children. To date, there is no definitive evidence to guide treatment of SE refractory to benzodiazepines. The main objectives of treatment protocols are to expedite therapeutic decisions and to use fast- and short-acting medications without significant adverse effects. Protocols differ among institutions, and most frequently valproate, phenytoin, and levetiracetam are used as second-line treatment. After failure of first- and second-line medications, admission to the intensive care unit and continuous infusion of anesthetics are usually indicated...
April 2023: Epilepsia
https://read.qxmd.com/read/36750971/profile-of-liver-cholestatic-biomarkers-following-prolonged-ketamine-administration-in-patients-with-covid-19
#19
JOURNAL ARTICLE
Julie Henrie, Ludovic Gerard, Caroline Declerfayt, Adrienne Lejeune, Pamela Baldin, Arnaud Robert, Pierre-François Laterre, Philippe Hantson
BACKGROUND: To investigate the possible influence of prolonged ketamine (K) or esketamine (ESK) infusion on the profile of liver cholestatic biomarkers in patients with COVID-19 infection. METHODS: A retrospective analysis was performed on 135 patients with COVID-19 related ARDS who received prolonged K or ESK infusion. They were compared to 15 COVID-19 ICU patients who did not receive K/ESK while being mechanically ventilated and 108 COVID-19 patients who did not receive mechanical ventilation nor K/ESK...
February 7, 2023: BMC Anesthesiology
https://read.qxmd.com/read/36567489/is-ketamine-infusion-effective-and-safe-as-an-adjuvant-of-sedation-in-the-picu-results-from-the-ketamine-infusion-sedation-study-kiss
#20
JOURNAL ARTICLE
Anna Tessari, Francesca Sperotto, Federico Pece, Giulia Pettenuzzo, Nicola Porcellato, Elisa Poletto, Maria Cristina Mondardini, Andrea Pettenazzo, Marco Daverio, Angela Amigoni
STUDY OBJECTIVE: We aimed to evaluate the efficacy and safety of ketamine in ensuring comfort and sparing conventional drugs when used as an adjuvant for analgesia and sedation in the Pediatric Intensive Care Unit (PICU) as a continuous infusion (≥12 h). DESIGN: Observational prospective study. SETTING: Tertiary-care-center PICU. PATIENTS: All consecutive patients <18 years who received ketamine for ≥12 h between January 2019 and July 2021...
December 25, 2022: Pharmacotherapy
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