Related Experiment Video

Updated: Jan 5, 2026

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
07:27

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

Published on: August 19, 2020

12.3K

Effects of continuous ketamine infusion on hemodynamics and mortality in critically ill children

Sojin Park1, Ah Young Choi2, Esther Park2

  • 1Department of Pharmaceutical Services, Samsung Medical Center, Seoul, Republic of Korea.

Plos One
|October 19, 2019
PubMed

Insights

Continuous ketamine infusion in pediatric intensive care units (PICUs) did not significantly alter blood pressure or vasopressor use. This sedative agent can be safely administered without causing hemodynamic instability in critically ill children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pharmacology
  • Hemodynamics

Background:

  • Continuous sedation is common in pediatric intensive care units (PICUs).
  • Ketamine is an anesthetic agent with potential sedative properties.
  • Limited data exists on the hemodynamic and mortality effects of continuous ketamine infusion in critically ill children.

Purpose of the Study:

  • To investigate the hemodynamic and mortality effects of continuous ketamine infusion in critically ill pediatric patients.
  • To compare vital signs, vasopressor use, and sedation/pain scores before and after ketamine initiation.
  • To assess the association between continuous ketamine and mortality.

Main Methods:

  • Retrospective cohort study in a tertiary PICU.
  • Included patients receiving continuous sedation for ≥24 hours between 2015-2017.
  • Compared hemodynamic parameters and vasogenic medication use 12 hours pre- and post-ketamine initiation.
  • Multivariate logistic regression used to compare mortality rates between ketamine and non-ketamine groups.

Main Results:

  • 82 patients received continuous ketamine (median infusion rate 8.1 mcg/kg/min, median duration 6 days).
  • Heart rate and respiratory rate decreased significantly after ketamine infusion (P=.033 and P=.001, respectively).
  • Blood pressure and vasogenic medication use did not change significantly.
  • Continuous ketamine was not a significant risk factor for mortality (HR 1.352, CI 0.458-3.996).

Conclusions:

  • Continuous ketamine infusion can be used in PICU settings without inducing significant hemodynamic instability.
  • Further randomized controlled trials are needed to confirm these findings on hemodynamics, sedation, and mortality.

More Related Videos

Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents07:52

Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents

Published on: June 2, 2015

12.5K
Continuous Video Electroencephalogram during Hypoxia-Ischemia in Neonatal Mice09:29

Continuous Video Electroencephalogram during Hypoxia-Ischemia in Neonatal Mice

Published on: June 11, 2020

3.7K

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
540
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
202
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
703
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
204
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
184
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
163