ISSN: 2642-1143
Authors: Muhammad H Gul*, Suresh Kumar and Zin Mar Htun
Status asthmaticus is a life-threatening condition with significant morbidity and mortality. There is limited experience with the use of ketamine intravenous infusion as a sedative in mechanically ventilated status asthmaticus patients. We are reporting a case of mechanically ventilated status asthmaticus patient being successfully managed with prolonged use of ketamine infusion. A 20-year-old female with a history of asthma was admitted for acute severe asthma exacerbation. She had worsening acute hypercarbic respiratory failure despite the treatment with a traditional bronchodilator, steroids, and magnesium, and she was intubated. She became hypotensive with the use of propofol and was started on ketamine infusion, which was continued for four days. Ketamine provided better sedation, blood pressure stability, and gradual improvement in bronchospasm, which led to the successful extubation and resolution of the asthma attack. She did not report any nightmares or dreams with the use of ketamine. Prolonged use of ketamine infusion has not been studied in acute asthma exacerbation. We report a case where ketamine infusion was successfully used for four days in an intubated patient with status asthmaticus without any significant side effects.
Keywords: Ketamine; Asthmaticus; Cisatracurium; Extubation