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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 into an asthma exacerbation which is a medical emergency. Purpose:

• To determine the efficacy of ketamine use as an adjunctive medication for acutes severe asthma exacerbations that had failed standard guideline directed treatments. Methods: • Relevant databases were searched looking for ketamine use in asthma exacerbations.

• The inclusion material consists of pediatric and adult populations in available systematic reviews, randomized control trials, meta-analysis, pilot studies, case reports, and peer-reviewed journal articles. Findings:

• Preliminary results showed no positive outcomes of improvement in asthma symptoms with low dose ketamine.

• Several findings point to noteworthy positive outcomes with an intravenous ketamine high dissociative dosing administration.

• In a small case report the use of nebulized ketamine showed promise at reversing the airway obstruction promptly. Implications:

• Some experts feel strongly that the dose ranges and duration of treatment play a key role into the efficacy of ketamine used as a pharmacological option.

• More research is needed with larger, high quality, randomized studies that addresses and objectively measures varying dosage regimens to form a consensus on the efficacy of ketamine use in refractory asthma exacerbations.


Physician Assistant Studies

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: Asthma, acute asthma exacerbation, asthma standardized practice guidelines, ketamine, ketamine in asthma exacerbations, severe asthma, status asthmaticus


Medicine and Health Sciences

Ketamine in Refractory Asthma Exacerbations