Ketamine Clinical Use on the Pediatric Critically Ill Infant: A Global Bibliometric and Critical Review of Literature

J Clin Med. 2023 Jul 12;12(14):4643. doi: 10.3390/jcm12144643.

Abstract

The developing central nervous system is vulnerable to several stimuli, especially psychotropic drugs. Sedation procedures during the developmental period are frequent in pediatric intensive care units (PICUs), in which the use of the sedative agent is still a challenge for the PICU team. Ketamine has been indicated for sedation in critically ill children with hemodynamic and ventilatory instabilities, but the possible neurobehavioral consequences related to this use are still uncertain. Here, we performed a bibliometric analysis with conventional metrics and a critical review of clinical findings to reveal a gap in the literature that deserves further investigation. We revealed that only 56 articles corresponded to the inclusion criteria of the study. The United States of America emerges as the main country within the scope of this review. In addition, professional clinical societies play a key role in the publications of scientific clinical findings through the specialist journals, which encourages the sharing of research work. The co-occurrence of keywords evidenced that the terms "sedation", "ketamine", and "pediatric" were the most frequent. Case series and review articles were the most prevalent study design. In the critical evaluation, the scarce studies highlight the need of use and post-use monitoring, which reinforces the importance of additional robust clinical studies to characterize the possible adverse effects resulting from ketamine anesthetic protocol in critically ill children.

Keywords: bibliometric study; ketamine; pediatric intensive care units; pediatric patient; sedation; sedoanalgesia.

Publication types

  • Review

Grants and funding

This work was funded by a Research Productivity Grant awarded to Dr. Cristiane do Socorro Ferraz Maia (grant number 311335/2019-5) by the Conselho Nacional de Desenvolvimento Científico e Tecnológico–CNPq/Brazil, and by the Research Pro-Rectory of the Federal University of Pará (PROPESP, UFPA, Brazil), which provided the article publication fee.