Ketamine in Critically Ill Patients: Use, Perceptions, and Potential Barriers
Carolyn M Bell1, Megan A Rech2, Kwame A Akuamoah-Boateng3
1Department of Pharmacy, Medical University of South Carolina, Charleston, SC, USA.
Journal of Pharmacy Practice
|October 25, 2022
Summary
Critical care practitioners are comfortable using ketamine for various procedures but inconsistently apply its use. Barriers include adverse effects and lack of routine use, indicating a need for targeted education on appropriate ketamine administration.
Area of Science:
- Critical care medicine
- Pharmacology
Background:
- Ketamine is an anesthetic with analgesic and sedative properties.
- Its use in acute and critically ill patients is increasing.
- Understanding practitioner use and barriers is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate practitioner use of ketamine in acutely and critically ill patients.
- To identify barriers to ketamine use.
- To compare users and non-users of ketamine.
Main Methods:
- An online survey was distributed to members of the Society of Critical Care Medicine (SCCM).
- The survey queried self-reported practices, beliefs, and barriers regarding ketamine use.
- 341 responses were analyzed.
Main Results:
- Most clinicians were comfortable using ketamine for intubation, analgesia, and sedation.
- Fewer clinicians were comfortable using ketamine for alcohol withdrawal or opioid detoxification.
- Common barriers included adverse effects, lack of routine use by peers, and insufficient evidence or familiarity.
Conclusions:
- While critical care practitioners are generally comfortable with ketamine, significant practice inconsistencies exist regarding dosing and indications.
- Barriers such as adverse effects and peer non-use hinder optimal ketamine application.
- Targeted educational interventions are needed to improve appropriate ketamine use in critical care settings.
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