Date of Award

5-2021

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Julie Solberg

Keywords

Asthma; Acute asthma exacerbation; Asthma standardized practice guidelines; Ketamine; Ketamine in asthma exacerbations; Severe asthma; Status asthmaticus

Abstract

Asthma is a chronic, non-curable respiratory disease that has multi-factorial effects on the bronchial mucosa. Despite optimal prevention and standardized first-line asthma care, the symptoms can deteriorate, leading to an asthma exacerbation, which is a medical emergency. The purpose of this review was to determine the efficacy of ketamine use as an adjunctive medication for acute asthma exacerbations that had failed standard guideline-directed treatments. Relevant databases included searches looking for ketamine use in asthma. Ketamine can be used as an adjunctive medication and has been found to be beneficial in stopping the emergency's progression by alleviating bronchospasms, increasing oxygen availability, reducing respiratory failure leading to mechanical ventilation, and decreasing mortality. Preliminary results showed no positive outcomes of improvement in asthma symptoms with low dose ketamine. Several findings point to remarkable positive outcomes with an intravenous high dissociative dosing administration. Some experts feel strongly that the dose ranges and duration of treatment play a vital role in the efficacy of ketamine used as a pharmacological option. More research is needed with more extensive, high-quality, randomized studies that address and objectively measures varying dosage regimens to form a consensus on the efficacy of ketamine use in refractory asthma exacerbations.

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