Ketamine Use in COPD Patients

Potential Benefits

Ketamine causes bronchodilation, which may be particularly beneficial for patients with COPD, especially during acute exacerbations or procedures requiring sedation 1, 2
Provides hemodynamic stability through its sympathomimetic effects, which can be advantageous in hemodynamically compromised COPD patients 1, 3

Ketamine increases upper airway secretions, which can potentially worsen respiratory symptoms in COPD patients 1, 2
Premedication with anticholinergics (atropine or preferably glycopyrrolate) is recommended to reduce secretions when using ketamine in COPD patients 1, 2
Ketamine produces a dose-dependent increase in heart rate, blood pressure, and cardiac output through sympathetic stimulation 3
Should be avoided in COPD patients with comorbid ischemic heart disease, cerebrovascular disease, or hypertension due to these cardiovascular effects 3

Consider ketamine in COPD patients requiring sedation when bronchodilation would be beneficial 1, 2
Consider ketamine in COPD patients who are hemodynamically compromised 3
Always administer ketamine with an anticholinergic agent to reduce secretions 1, 2
Monitor for increased secretions requiring suctioning 1, 2
Monitor for cardiovascular effects (increased heart rate, blood pressure) 3
Monitor for emergence reactions (can be reduced by co-administration with midazolam) 3