Table 1. Summary of included studies.
PaO2, partial pressure of oxygen in arterial blood; FiO2, fraction of inspiratory oxygen concentration; SpO2, oxygen saturation; T0, prior to ketamine use; T1, 1 h after ketamine infusion; TW, when the ketamine was discontinued; CAS, clinical asthma score
| Author | Year | Study design | Number of patients | Age | Mean age (years) | Ketamine dose | Duration | Intubation | Measures of improvement | Results | Adverse effects | |
| Petrillo et al. [10] | 2001 | Prospective observational study | 10 | 5-16 years | 8 | IV bolus 1 mg/kg followed by a continuous infusion of 0.75 mg/kg/h (12.5 mcg/kg/min). | 1 h | No | CAS, peak expiratory flow, and vital signs | The study showed a significant decrease in the asthma score, improved peak expiratory flow, reduced respiratory rate, and enhanced oxygen saturation | Mild side effects (hallucinations, flushing, hypertension) in four patients were resolved with medication or discontinuation. | |
| Youssef et al. [11] | 1996 | Retrospective chart review | 17 | 5 months-17 years | 6 +/- 5.7 | IV bolus 2 mg/kg, followed by continuous infusions of 20-60 mcg/kg per minute (32 +/- 10 mcg/kg per minute) | 40 h (12-96) | Yes | PaO2/FIO2, and dynamic compliance | PaO2/FIO2 ratio significantly increased after ketamine infusion at 1, 8, and 24 h. Dynamic compliance also improved. | One patient required glycopyrrolate for airway secretions, while another needed diazepam for ketamine-related hallucinations | |
| Kshirsagar et al. [12] | 2013 | Prospective observational study | 20 | 2 months-2 years | - | IV bolus 1 mg/kg followed by a continuous infusion of 10 mcg/kg/min (continuous infusion was given in 14 pts) | Average 15 h | No | Uyan score and SpO2 | Uyan score significantly improved (T0: 13.14 ± 1.17, T1: 9.82 ± 1.21, TW: 0.5 ± 0.65). SpO2 also showed significant improvement (T0: 87.71% ± 2.05%, T1: 92.64% ± 2.46%, TW: 99.5% ± 0.51%). | None | |
| Allen and Macias [13] | 2005 | Double-blinded, randomized, placebo-controlled trial | 68 | 2-18 years | 6.1 +/- 4.0 | IV bolus 0.2 mg/kg followed by a 2-h ketamine infusion at 0.5 mg/kg/h | 2 h | No | Pulmonary Index Score | No significant difference between groups | None | |
| Tiwari et al. [14] | 2016 | Randomized, open-label, controlled trial | 48 | 16 months-12 years | 4 | 0.5 mg/kg bolus over 20 min, followed by continuous infusion of 0.6 mg/kg/h for 3 h | 3 h | No | PRAM score | Similar primary outcomes were observed in both groups: ketamine (4.00 ± 1.25) and aminophylline (4.17 ± 1.68) with respect to PRAM score changes. | In the ketamine group, two patients experienced hypertension. Tachycardia was observed in both groups at enrollment and persisted after 3 h. Aside from one episode of vomiting in a patient from the ketamine group, no other adverse effects were reported in either group | |