Ketamine Sedation in the ICU (KANINE) RCT

Launched by MCMASTER UNIVERSITY · Jan 5, 2025

Keywords

ClinConnect Summary

The KANINE trial is a study looking at whether adding ketamine, a medication that helps with sedation and pain relief, can improve care for adults in the intensive care unit (ICU) who are on a breathing machine. Many ICU patients experience discomfort and anxiety, and while sedation helps, it can have side effects. This study will compare patients receiving standard sedation care with those receiving ketamine to see if it leads to better outcomes, like shorter time on the breathing machine or less confusion during recovery.

To participate, patients must be 18 years or older and have been on a breathing machine for at least 24 hours but less than three days. The study will include a variety of patients, but those with certain conditions such as severe liver disease or specific brain injuries will not be eligible. Throughout the trial, patients and their families will be kept informed about their care, and neither the patients nor the doctors will know who receives ketamine to ensure fair results. Ultimately, this research aims to find safer and more effective ways to manage sedation in critically ill patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients (≥ 18 years) admitted to the ICU
• • Intubated via endotracheal tube for at least 24 hours
• • Mechanically ventilated for fewer than 3 days
• • Receiving any non-ketamine continuous sedative infusion
• Exclusion Criteria:
• • Admitted with a primary diagnosis of intracranial hemorrhage, traumatic brain injury, or stroke
• • Admitted with uncontrolled hypertension (SBP/DBP \> 180/100mmHg)
• • Schizophrenia
• • End-stage Liver Failure (Child-Pugh C)
• • Requiring an equivalent of norepinephrine at a dose ≥1mcg/kg/min
• • Undergoing palliation or comfort care
• • On neuromuscular blocking agent
• • Pre-existing tracheostomy
• • Hypersensitivity to Ketamine
• • Liver transplantation in the last month
• • Pregnant or breast-feeding