KETAMINE FOR THE PREVENTION OF DELIRIUM IN CRITICALLY ILL ADULT PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS Chest SAAD QM, FARIS ME, ADHIKARI P. KETAMINE FOR THE PREVENTION OF DELIRIUM IN CRITICALLY ILL ADULT PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Date
10/11/2023Abstract
PURPOSE: Ketamine is a commonly used analgesic and sedative agent in critical care settings. However, recent studies have
reported conflicting evidence regarding its impact on delirium incidence among critically ill patients. In this meta-analysis, our
aim was to investigate the role of ketamine in preventing delirium in this patient population.
METHODS: A thorough search of PubMed, Embase, Web of Science, and Cochrane databases was carried out from their
inception to March 2023, to identify relevant randomized controlled trials (RCTs) that analyzed the effect of ketamine on delirium
in adult patients admitted to intensive care units (ICUs) when compared with either placebo or other sedatives. The primary
outcome was the incidence of ICU-delirium, while secondary outcomes included mortality rate, length of ICU stay, days on
mechanical ventilation, and adverse events. Meta-analyses were carried out using random-effects models.
RESULTS: A total of eight RCTs with 1210 participants were included in the meta-analysis. The results demonstrated no
significant difference in the incidence of delirium between the ketamine and placebo or other sedative groups (17.14% vs 21.26%;
OR 0.70, 95% CI 0.45 to 1.08; p ΒΌ 0.109). There was no statistical difference in 28-day mortality, length of ICU stay, mechanical
ventilation requirement, or overall adverse events between the two groups.
CONCLUSIONS: Our meta-analysis indicates that there is no effect of ketamine on delirium incidence compared to placebo or
other sedatives among critically ill adult patients admitted to ICU.
CLINICAL IMPLICATIONS: Based on our findings, it appears that ketamine does not play a role in preventing delirium in
critically ill adult patients. Further research is required to identify effective alternatives for preventing and treating ICU delirium.
Author List
QINGQING MENG AKSHAYA RAMACHANDRAN ELTAIB SAAD, MOHAMMED ELAMIN FARIS, PABITRA ADHIKARIAuthor
Mohammed Elamin Faris MBBS Assistant Professor in the Medicine department at Medical College of WisconsinView Online
