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
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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.