Ketamine by continuous infusion in status asthmaticus

A 13-year-old girl was admitted to the intensive care unit with status asthmaticus. Conventional bronchodilator therapy failed to relieve her bronchospasm. In order to try and avoid artificial ventilation, a continuous intravenous infusion of ketamine was used with success. The total dose rate was 40 micrograms/kg minute for a period of 8 hours; this was given at a decreasing rate. She regained consciousness 30 minutes after the end of the infusion and became well orientated after one hour. Ketamine is a useful drug in the intensive treatment of status asthmaticus and should be tried before a decision is taken to start mechanical ventilation.