Use of ketamine for severe asthma exacerbation in a pregnant patient with persistent bronchospasm: a case report

Abstract

Background: Estimated 4%-8% of pregnancies are complicated by asthma. Adequate management in this population is critical to minimize complications. Patients presenting with asthma exacerbation are typically managed with standard bronchodilators and systemic corticosteroids. However, additional agents may be used in patients with refractory asthma exacerbation. Ketamine has been used in refractory bronchospasm, although its efficacy in published literature is heterogeneous.

Case Presentation: We present a case of a pregnant patient with severe asthma exacerbation refractory to standard and salvage treatment who achieved termination of bronchospasm with ketamine infusion.

Conclusion: After receiving ketamine infusion for several days, the patient had improved air flow and achieved successful extubation, without experiencing rebound bronchospasm. Although this individual clinical case alone cannot change guidelines or directives to use in refractory asthma exacerbations, it offers a possible treatment option to patients and providers in unusually severe cases with extenuating risk factors.

Keywords

Asthma / Bronchospasms / Case Report / Ketamine / Pregnancy

Conflict of interest statement

The authors declare no conflict of interest.

Author contributions

Johnson M, Abbas M, and Jones J participated in the design and literature review of the case report. All authors participated in writing and reviewing the article.

Funding

None.

Ethical approval of studies and informed consent

The study followed the principles of the Declaration of Helsinki as revised in 2013. The International Review Board (IRB) Ethics Committee of Beaumont Hospital states that the publication of single patient case report is exempt from IRB approval. Written informed consent was obtained from the patient. This manuscript has the consent of the patient for the use of her data and for the publication of the data that appear in the article.

Acknowledgments

None.

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