Long-term ketamine infusion-induced cholestatic liver injury in COVID-19-associated acute respiratory distress syndrome

Wendel Garcia, Pedro David; Erlebach, Rolf; Hofmaenner, Daniel Andrea; Camen, Giovanni; Schuepbach, Reto Andreas; Jüngst, Christoph; Müllhaupt, Beat; Bartussek, Jan; Buehler, Philipp Karl; Andermatt, Rea; David, Sascha

doi:10.1186/s13054-022-04019-8

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Wendel Garcia, P. D., Erlebach, R., Hofmaenner, D. A., Camen, G., Schuepbach, R. A., Jüngst, C., Müllhaupt, B., Bartussek, J., Buehler, P. K., Andermatt, R., & David, S. (2022). Long-term ketamine infusion-induced cholestatic liver injury in COVID-19-associated acute respiratory distress syndrome. Critical Care, 26, 148. https://doi.org/10.1186/s13054-022-04019-8

Abstract

Background: A higher-than-usual resistance to standard sedation regimens in COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) has led to the frequent use of the second-line anaesthetic agent ketamine. Simultaneously, an increased incidence of cholangiopathies in mechanically ventilated patients receiving prolonged infusion of high-dose ketamine has been noted. Therefore, the objective of this study was to investigate a potential dose–response relationship between ketamine and bilirubin levels. Methods: Post h