title: Low-Dose Ketamine in Chronic Critical Illness.
abstract: We report a case series on the observed effects of low-dose ketamine infusions in 4 critically ill patients with varying complications related to prolonged critical illness. Doses of ketamine infusion ranged from 0.5 to 4 μg/kg/min. A low-dose ketamine infusion was used to reduce agitation in a patient requiring high doses of sedatives and analgesics. In a second patient, ketamine improved depression and anxiety symptoms. In a third patient, ketamine may have facilitated liberation from mechanical ventilation. In a fourth patient, ketamine was used for palliation to avoid lethargy. Ketamine may be considered to help decrease agitation, manage pain, facilitate opioid and benzodiazepine withdrawal, prevent respiratory depression, and potentially manage depression and anxiety in chronically critically ill patients.
authors.affiliation: Department of Anesthesiology, College of Physicians & Surgeons, Columbia University, New York, NY, USA Vm2161@cumc.columbia.edu.
authors.forename: Vivek K
authors.initials: VK
authors.lastname: Moitra
authors.affiliation: Department of Pharmacy, New York Presbyterian Hospital, Columbia University, New York, NY, USA.
authors.forename: Mona K
authors.initials: MK
authors.lastname: Patel
authors.affiliation: Department of Anesthesiology, College of Physicians & Surgeons, Columbia University, New York, NY, USA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Darrah
authors.affiliation: Department of Pharmacy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Alika
authors.initials: A
authors.lastname: Moitra
authors.affiliation: Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Hannah
authors.initials: H
authors.lastname: Wunsch
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D001007:Anxiety / Q000188:drug therapy* / Q000523:psychology; D002908:Chronic Disease; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives; D007649:Ketamine
keywords: analgesia; chronic critical illness; depression; ketamine; sedation