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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

26.10.2023 | Reports of Original Investigations

Ketamine sedation in the intensive care unit: a survey of Canadian intensivists

verfasst von: Sameer Sharif, MD, MSc, Laveena Munshi, MD, MSc, Lisa Burry, PharmD, Sangeeta Mehta, MD, Sara Gray, MD, Dipayan Chaudhuri, MD, MSc, Mark Duffett, PhD, Reed A. Siemieniuk, MD, PhD, Bram Rochwerg, MD, MSc

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 1/2024

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Abstract

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. The survey was redistributed in January 2023 to improve the response rate.

Results

We received 87/400 (22%) completed questionnaires. Most respondents reported they rarely use ketamine as a continuous infusion for sedation or analgesia in the ICU (52/87, 58%). Physicians reported the following conditions would make them more likely to use ketamine: asthma exacerbation (73/87, 82%), tolerance to opioids (68/87, 77%), status epilepticus (44/87, 50%), and severe acute respiratory distress syndrome (33/87, 38%). Concern for side-effects that limited respondents’ use of ketamine include adverse psychotropic effects (61/87, 69%) and delirium (47/87, 53%). The majority of respondents agreed there is need for an RCT to evaluate ketamine as a sedative infusion in the ICU (62/87, 71%).

Conclusion

This survey of Canadian intensivists illustrates that use of ketamine as a continuous infusion for sedation is limited, and is at least partly driven by concerns of adverse psychotropic effects. Canadian physicians endorse the need for a trial investigating the safety and efficacy of ketamine as a sedative for critically ill patients.

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Titel: Ketamine sedation in the intensive care unit: a survey of Canadian intensivists
verfasst von: Sameer Sharif, MD, MSc
Laveena Munshi, MD, MSc
Lisa Burry, PharmD
Sangeeta Mehta, MD
Sara Gray, MD
Dipayan Chaudhuri, MD, MSc
Mark Duffett, PhD
Reed A. Siemieniuk, MD, PhD
Bram Rochwerg, MD, MSc
Publikationsdatum: 26.10.2023
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 1/2024
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02608-x

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Ketamine sedation in the intensive care unit: a survey of Canadian intensivists