Role of ketamine in life-threatening asthma exacerbation

Abstract

Ketamine in life-threatening asthma exacerbation might be a novel approach to avoid the need for intubation and or invasive mechanical ventilation or asthma-related lethal outcomes. We present a case of a young man who presented with life-threatening asthma exacerbation who along with standard medications, improved with the addition of intravenous ketamine to his treatment regime. A 36 years old male farmer who was known to have asthma was referred from a Primary Health Centre Clinic with suspected life-threatening asthma. He was treated previously before arrival to our ED with nebulizers and IV Corticosteroids. In the ED, the patient received IV magnesium and IM Epinephrine. Intubation was anticipated, and the induction agent of Ketamine was considered. However, given there were anecdotal cases of patients responding to Ketamine Infusion, a bolus dose of 0.5mg/kg was given, and an infusion at a similar dose per hour was started. The patient began to respond gradually and was later admitted to ICU. Ketamine may have a role in life-threatening asthma. In our case, we used a low dose of ketamine infusion to try and avoid the need for intubation and mechanical ventilation and were successful.