تقرير
Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient.
| العنوان: | Long-lasting neurocognitive disorders: a case report of previously undescribed adverse effects after ketamine sedation and analgesia in a pediatric patient. |
|---|---|
| المؤلفون: | Machado-Ferraro KM; Post-Graduate Program in Pharmacology and Biochemistry, Federal University of Pará, Belém, Pará, Brazil.; Hospital Fundação Santa Casa de Misericórdia do Pará (FSCMP), Unidade Materno Infantil Dr. Almir Gabriel, Belém, Pará, Brazil.; Laboratory of Pharmacology of Inflammation and Behavior, Faculty of Pharmacy, Health Science Institute, Federal University of Pará, Belém, Pará, Brazil., Soriano-de-Mello DS; University Center of Pará-CESUPA, Belém, Pará, Brazil., de Moura IP; University Center of Pará-CESUPA, Belém, Pará, Brazil., da Silveira CCSM; Laboratory of Pharmacology of Inflammation and Behavior, Faculty of Pharmacy, Health Science Institute, Federal University of Pará, Belém, Pará, Brazil., de Farias ECF; Hospital Fundação Santa Casa de Misericórdia do Pará (FSCMP), Unidade Materno Infantil Dr. Almir Gabriel, Belém, Pará, Brazil., Maia MLF; Post-Graduate Program in Pharmacology and Biochemistry, Federal University of Pará, Belém, Pará, Brazil.; Hospital Fundação Santa Casa de Misericórdia do Pará (FSCMP), Unidade Materno Infantil Dr. Almir Gabriel, Belém, Pará, Brazil., de Sales SCD; Hospital Fundação Santa Casa de Misericórdia do Pará (FSCMP), Unidade Materno Infantil Dr. Almir Gabriel, Belém, Pará, Brazil., Carvalho AEV; University Center of Pará-CESUPA, Belém, Pará, Brazil., Magno IMN; University Center of Pará-CESUPA, Belém, Pará, Brazil., Fontes-Júnior EA; Laboratory of Pharmacology of Inflammation and Behavior, Faculty of Pharmacy, Health Science Institute, Federal University of Pará, Belém, Pará, Brazil., Maia CSF; Post-Graduate Program in Pharmacology and Biochemistry, Federal University of Pará, Belém, Pará, Brazil.; Laboratory of Pharmacology of Inflammation and Behavior, Faculty of Pharmacy, Health Science Institute, Federal University of Pará, Belém, Pará, Brazil. |
| المصدر: | Annals of translational medicine [Ann Transl Med] 2022 Jan; Vol. 10 (2), pp. 113. |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101617978 Publication Model: Print Cited Medium: Print ISSN: 2305-5839 (Print) Linking ISSN: 23055839 NLM ISO Abbreviation: Ann Transl Med Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Hong Kong] : AME Publishing Company |
| مستخلص: | This case report describes the long-term behavioral and cognitive alterations in a critically ill pediatric patient submitted to a ketamine sedation and analgesia protocol for 7 consecutive days in a pediatric intensive care unit. The infant exhibited withdrawal syndrome in the early withdrawal period, as measured using the Withdrawal Assessment Tool-1 (WAT-1). In the days following ketamine withdrawal, behavioral, motor, and cognitive impairment was observed, even after hospital discharge. At 20 days after admission to hospital, the infant still displayed language deficits compatible with the at-risk category for the appropriate age group on the development assessment (Denver-II Developmental Screening Test). The infant's mother reported that these impairments were not present before ketamine sedation. We therefore suggest that prolonged ketamine use may have contributed to the long-lasting behavioral and cognitive impairments observed in the critically ill infant. These adverse effects may be attributable to ketamine's pharmacological mechanism of action, by which the N-methyl-D-aspartate receptor-the central nervous system excitatory receptor responsible for memory and learning domains-is blockaded, disrupting long-term potentiation events. Our case highlights the need for clinical evaluation of ketamine agents and their associated risks in intensive care units to better clarify appropriate sedative and analgesic agents during neurodevelopmental periods of life. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view//10.21037/atm-21-2292/coif). The authors have no conflicts of interest to declare. (2022 Annals of Translational Medicine. All rights reserved.) |
| References: | Toxicol Sci. 2007 Jul;98(1):145-58. (PMID: 17426105) Pain. 2012 Jan;153(1):142-148. (PMID: 22093817) Paediatr Anaesth. 2017 Nov;27(11):1098-1107. (PMID: 29030928) Paediatr Anaesth. 2011 Jul;21(7):716-21. (PMID: 21466608) Health Technol Assess. 2016 Mar;20(25):v-xx, 1-117. (PMID: 27035758) Pediatr Crit Care Med. 2015 Mar;16(3):210-8. (PMID: 25581629) Pharmacol Biochem Behav. 2007 Feb;86(2):189-99. (PMID: 17222895) PLoS One. 2019 Oct 18;14(10):e0224035. (PMID: 31626685) Neurosci Lett. 2018 Apr 23;673:122-131. (PMID: 29501685) Semin Perinatol. 2007 Oct;31(5):303-8. (PMID: 17905185) Nat Rev Neurosci. 2018 Feb 16;19(3):123-137. (PMID: 29449712) JAMA. 2000 Mar 15;283(11):1451-9. (PMID: 10732935) Anesth Analg. 1974 May-Jun;53(3):380-2. (PMID: 4856931) Mol Med Rep. 2018 May;17(5):6873-6880. (PMID: 29512789) Addiction. 2010 Jan;105(1):121-33. (PMID: 19919593) Oxid Med Cell Longev. 2019 Mar 14;2019:5452727. (PMID: 31001375) Anesthesiology. 2007 Sep;107(3):427-36. (PMID: 17721245) J Pediatr Intensive Care. 2019 Sep;8(3):156-163. (PMID: 31402992) Anesthesiology. 2009 Apr;110(4):796-804. (PMID: 19293700) Curr Opin Neurobiol. 1997 Apr;7(2):235-42. (PMID: 9142751) |
| فهرسة مساهمة: | Keywords: Ketamine; behavioral impairment; case report; neurological disorders; sedation |
| تواريخ الأحداث: | Date Created: 20220314 Latest Revision: 20220315 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC8848358 |
| DOI: | 10.21037/atm-21-2292 |
| PMID: | 35282119 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2305-5839 |
|---|---|
| DOI: | 10.21037/atm-21-2292 |