In this retrospective study, we observed that younger patients with acute respiratory distress syndrome (ARDS) may benefit from ketamine use in terms of 14-day mortality.

However, these benefits were not observed in longer-term survival outcomes.

Overall, the effect of ketamine on mortality appears to be limited.

In clinical practice, the preferential use of ketamine for patients with extended duration of mechanical ventilation (MV) may introduce bias into the analysis of survival outcomes.

This study contributes real-world evidence to the understanding of ketamine’s impact on mortality in the ICU.

Further prospective studies are warranted to elucidate the impact of ketamine use on mortality in critically ill patients with ARDS.

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