Open AccessReversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report
Author(s) -
Fahisham Taib,
Laila Ab Mukmin
Publication year - 2020
Publication title -
malaysian journal of paediatrics and child health
Language(s) - English
Resource type - Journals
ISSN - 1511-4511
DOI - 10.51407/mjpch.v26i2.80
Subject(s) - medicine , midazolam , ketamine , anesthesia , bronchospasm , dexmedetomidine , delirium , intubation , mechanical ventilation , emergence delirium , refractory (planetary science) , hiccups , asthma , intensive care medicine , sedation , physics , astrobiology
Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.