The use of ketamine for the emergency intubation of patients with status asthmaticus

We describe five patients with status asthmaticus whose respiratory acidosis persisted despite conventional treatment. Four were intubated with ketamine and succinylcholine and mechanically ventilated with immediate improvement of respiratory acidosis. One patient had been intubated previously with diazepam and succinylocholine and had a rise in pCO2 to 97. Ketamine was given IV with a rapid fall in pCO2. This improvement immediately after intubation is in contrast to previous reports of asthmatics whose respiratory acidosis and bronchospasm worsened immediately after intubation.