Adult patients with septic shock, on hemodynamic support, had high-to-normal intracranial pressure (ICP). Low-dose continuous ketamine infusion as an adjunct sedative appeared to have favorable outcomes concerning ICP and hemodynamic monitoring and was associated with a significant reduction in doses of sedative and vasopressor.

Further studies with a larger number of patients and longer duration are needed to support the study findings, especially in patients with septic encephalopathy and/or low GCS scores.

An interventional study was conducted at the intensive care unit of Zagazig University Hospitals from December 2021 to March 2023 and covered 100 adult patients with septic shock requiring mechanical ventilation, sedation, and vasopressors.

Patients with acute brain injury were excluded. Noninvasive ICP including ICP derived from pulsatility index, ICP derived from diastolic flow velocity (ICPFVd), and ICP derived from optic nerve sheath diameter, and hemodynamic monitoring were measured before adjunct low-dosage (0.3 μg/kg/hr) continuous ketamine infusion (T0), after 12 h (T1), and after 24 h of infusion (T2).

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