@Article{duepublico_mods_00077505,
  author = 	{Suleiman, Aiman
		and Santer, Peter
		and Munoz-Acuna, Ronny
		and Hammer, Maximilian
		and Schaefer, Maximilian S.
		and Wachtendorf, Luca J.
		and Rumyantsev, Sandra
		and Berra, Lorenzo
		and Chamadia, Shubham
		and Johnson-Akeju, Oluwaseun
		and Baedorf-Kassis, Elias N.
		and Eikermann, Matthias},
  title = 	{Effects of Ketamine Infusion on Breathing and Encephalography in Spontaneously Breathing ICU Patients},
  year = 	{2022},
  month = 	{Aug},
  day = 	{08},
  keywords = 	{Ketamine infusion; ICU sedation; weaning from ventilator; spontaneous breathing trial; critical care ventilation; mechanical ventilation; inspiratory flow; brain activity},
  abstract = 	{Background: Preclinical studies suggest that ketamine stimulates breathing. We investigated whether adding a ketamine infusion at low and high doses to propofol sedation improves inspiratory flow and enhances sedation in spontaneously breathing critically ill patients. Methods: In this prospective interventional study, twelve intubated, spontaneously breathing patients received ketamine infusions at 5 mcg/kg/min, followed by 10 mcg/kg/min for 1 h each. Airway flow, pressure, and esophageal pressure were recorded during a spontaneous breathing trial (SBT) at baseline, and during the SBT conducted at the end of each ketamine infusion regimen. SBT consisted of one-minute breathing with zero end-expiratory pressure and no pressure support. Changes in inspiratory flow at the pre-specified time points were assessed as the primary outcome. Ketamine-induced change in beta-gamma electroencephalogram power was the key secondary endpoint. We also analyzed changes in other ventilatory parameters respiratory timing, and resistive and elastic inspiratory work of breathing. Results: Ketamine infusion of 5 and 10 mcg/kg/min increased inspiratory flow (median, IQR) from 0.36 (0.29-0.46) L/s at baseline to 0.47 (0.32-0.57) L/s and 0.44 (0.33-0.58) L/s, respectively ( p {\thinspace}={\thinspace}.013). Resistive work of breathing decreased from 0.4 (0.1-0.6) J/l at baseline to 0.2 (0.1-0.3) J/l after ketamine 10 mcg/kg/min ( p {\thinspace}={\thinspace}.042), while elastic work of breathing remained unchanged. Electroencephalogram beta-gamma power (19-44 Hz) increased compared to baseline ( p {\thinspace}<{\thinspace}.01). Conclusions In intubated, spontaneously breathing patients receiving a constant rate of propofol, ketamine increased inspiratory flow, reduced inspiratory work of breathing, and was associated with an ``activated'' electroencephalographic pattern. These characteristics might facilitate weaning from mechanical ventilation.},
  note = 	{<p>Suleiman, A., Santer, P., Munoz-Acuna, R., Hammer, M., Schaefer, M. S., Wachtendorf, L. J., Rumyantsev, S., Berra, L., Chamadia, S., Johnson-Akeju, O., Baedorf-Kassis, E. N., {\&}amp; Eikermann, M.: Effects of Ketamine Infusion on Breathing and Encephalography in Spontaneously Breathing ICU Patients. <em>Journal of Intensive Care Medicine</em>. 2023;38(3):299-306. doi:<a href="https://doi.org/10.1177/08850666221119716">10.1177/08850666221119716</a></p>

<p>First published online August 8, 2022</p>},
  note = 	{Version of Record / Verlagsversion},
  note = 	{deepgreen
<p>SAGE. Embargo 12 Monate, abgelaufen</p>},
  note = 	{<p>Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-gef{\"o}rderten) Allianz- bzw. Nationallizenz frei zug{\"a}nglich.</p>

<hr />
<p>This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.</p>},
  doi = 	{10.1177/08850666221119716},
  url = 	{https://duepublico2.uni-due.de/receive/duepublico_mods_00077505},
  url = 	{https://doi.org/10.1177/08850666221119716},
  file = 	{:https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00077158/J_Intensive_Care_Med_2023_38_3_299-306.pdf:PDF},
  language = 	{en}
}