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Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient
This case report describes the long-term behavioral and cognitive alterations in a critically ill pediatric patient submitted to a ketamine sedation and analgesia protocol for 7 consecutive days in a pediatric intensive care unit. The infant exhibited withdrawal syndrome in the early withdrawal peri...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848358/ https://www.ncbi.nlm.nih.gov/pubmed/35282119 http://dx.doi.org/10.21037/atm-21-2292 |
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author | Machado-Ferraro, Kissila M. Soriano-de-Mello, Débora S. de Moura, Isadora P. da Silveira, Cinthia C. S. M. de Farias, Emmerson C. F. Maia, Mary L. F. de Sales, Susan C. D. Carvalho, Ana Emilia V. Magno, Ismaelino M. N. Fontes-Júnior, Enéas A. Maia, Cristiane S. F. |
author_facet | Machado-Ferraro, Kissila M. Soriano-de-Mello, Débora S. de Moura, Isadora P. da Silveira, Cinthia C. S. M. de Farias, Emmerson C. F. Maia, Mary L. F. de Sales, Susan C. D. Carvalho, Ana Emilia V. Magno, Ismaelino M. N. Fontes-Júnior, Enéas A. Maia, Cristiane S. F. |
author_sort | Machado-Ferraro, Kissila M. |
collection | PubMed |
description | This case report describes the long-term behavioral and cognitive alterations in a critically ill pediatric patient submitted to a ketamine sedation and analgesia protocol for 7 consecutive days in a pediatric intensive care unit. The infant exhibited withdrawal syndrome in the early withdrawal period, as measured using the Withdrawal Assessment Tool-1 (WAT-1). In the days following ketamine withdrawal, behavioral, motor, and cognitive impairment was observed, even after hospital discharge. At 20 days after admission to hospital, the infant still displayed language deficits compatible with the at-risk category for the appropriate age group on the development assessment (Denver-II Developmental Screening Test). The infant’s mother reported that these impairments were not present before ketamine sedation. We therefore suggest that prolonged ketamine use may have contributed to the long-lasting behavioral and cognitive impairments observed in the critically ill infant. These adverse effects may be attributable to ketamine’s pharmacological mechanism of action, by which the N-methyl-D-aspartate receptor—the central nervous system excitatory receptor responsible for memory and learning domains—is blockaded, disrupting long-term potentiation events. Our case highlights the need for clinical evaluation of ketamine agents and their associated risks in intensive care units to better clarify appropriate sedative and analgesic agents during neurodevelopmental periods of life. |
format | Online Article Text |
id | pubmed-8848358 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-88483582022-03-10 Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient Machado-Ferraro, Kissila M. Soriano-de-Mello, Débora S. de Moura, Isadora P. da Silveira, Cinthia C. S. M. de Farias, Emmerson C. F. Maia, Mary L. F. de Sales, Susan C. D. Carvalho, Ana Emilia V. Magno, Ismaelino M. N. Fontes-Júnior, Enéas A. Maia, Cristiane S. F. Ann Transl Med Case Report This case report describes the long-term behavioral and cognitive alterations in a critically ill pediatric patient submitted to a ketamine sedation and analgesia protocol for 7 consecutive days in a pediatric intensive care unit. The infant exhibited withdrawal syndrome in the early withdrawal period, as measured using the Withdrawal Assessment Tool-1 (WAT-1). In the days following ketamine withdrawal, behavioral, motor, and cognitive impairment was observed, even after hospital discharge. At 20 days after admission to hospital, the infant still displayed language deficits compatible with the at-risk category for the appropriate age group on the development assessment (Denver-II Developmental Screening Test). The infant’s mother reported that these impairments were not present before ketamine sedation. We therefore suggest that prolonged ketamine use may have contributed to the long-lasting behavioral and cognitive impairments observed in the critically ill infant. These adverse effects may be attributable to ketamine’s pharmacological mechanism of action, by which the N-methyl-D-aspartate receptor—the central nervous system excitatory receptor responsible for memory and learning domains—is blockaded, disrupting long-term potentiation events. Our case highlights the need for clinical evaluation of ketamine agents and their associated risks in intensive care units to better clarify appropriate sedative and analgesic agents during neurodevelopmental periods of life. AME Publishing Company 2022-01 /pmc/articles/PMC8848358/ /pubmed/35282119 http://dx.doi.org/10.21037/atm-21-2292 Text en 2022 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Case Report Machado-Ferraro, Kissila M. Soriano-de-Mello, Débora S. de Moura, Isadora P. da Silveira, Cinthia C. S. M. de Farias, Emmerson C. F. Maia, Mary L. F. de Sales, Susan C. D. Carvalho, Ana Emilia V. Magno, Ismaelino M. N. Fontes-Júnior, Enéas A. Maia, Cristiane S. F. Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
title | Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
title_full | Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
title_fullStr | Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
title_full_unstemmed | Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
title_short | Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
title_sort | long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848358/ https://www.ncbi.nlm.nih.gov/pubmed/35282119 http://dx.doi.org/10.21037/atm-21-2292 |
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