The following is a summary of “Continuous Infusion of Ketamine in Mechanically Ventilated Patients with SARS-CoV-2,” published in the May 2024 issue of Critical Care by Phan et al.

Drug shortages in the ICU led to the exploration of ketamine as a potential treatment option, particularly for patients with SARS-CoV-2.

Researchers conducted a retrospective study assessing if continuous ketamine infusion affects vasopressor needs in patients with SARS-CoV-2.

They included adult patients with SARS-CoV-2 who were mechanically ventilated (MV) and received either propofol or ketamine for at least 72 hours.

The result showed data from 84 patients with a mean age of 61; 68% were male. The ketamine group consisted of 31 patients, while the propofol group had 53. The analysis of vasopressor revealed no significant difference between the groups at specific time points; mean arterial pressure (MAP) remained higher in the ketamine group at 24, 48, and 96 hours after starting sedation. Additionally, the ketamine group required less opioid medication compared to propofol (median dose: 3 vs. 12.5 mg/hour, P<0.0001). A marker of inflammation CRP, was lower in the ketamine group compared to propofol at 24 hours (7.53 vs. 15.9 mg/dL, P=0.03), 48 hours (5.23 vs. 14.1 mg/dL, P=0.0083), and 72 hours (6.4 vs. 12.1 mg/dL, P=0.0085).

Investigators concluded that patients with SARS-CoV-2 on mechanical ventilation ketamine use showed no difference in vasopressor need compared to propofol but correlated with higher MAP, reduced CRP levels at specific intervals, and overall decreased inflammation.

Source: onlinelibrary.wiley.com/doi/10.1155/2024/7765932