A Case of Hepatotoxicity Induced by Therapeutic Ketamine Use for Sedation.

Q3 Medicine Case Reports in Critical Care Pub Date : 2024-03-12 eCollection Date: 2024-01-01 DOI:10.1155/2024/8366034
Noah Yoo, Sarun Thomas, Michael Bender, Xian Jie Cindy Cheng
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Abstract

Ketamine, initially developed as an anesthetic, has shown versatility in medical applications, including pain management, treatment-resistant depression, and sedation in the intensive care unit (ICU). While generally well-tolerated, long-term use at high doses raises concerns about potential toxicities, particularly in the liver. We present a case of a 27-year-old female with a complex medical history who received ketamine infusion for ICU sedation and experienced a sudden rise in liver function tests (LFTs), indicating possible ketamine-induced liver injury (KILI). The patient's liver function normalized after ketamine discontinuation. KILI is infrequent with short-term ketamine use, but emerging case reports suggest it may be associated with chronic or intermittent exposure. The underlying mechanisms for KILI are not fully understood but may involve the accumulation of ketamine metabolites, causing direct toxic effects on the liver. As ketamine's use expands, especially in critical care settings, clinicians should be vigilant for the potential development of KILI. Further research is needed to better understand its risk factors and mechanisms, as early detection and management of KILI are crucial to ensuring patient safety and optimizing ketamine's therapeutic benefits.

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一例因治疗性使用氯胺酮镇静而诱发肝中毒的病例。
氯胺酮最初是作为麻醉剂开发的,现已在医疗应用中显示出多用途性,包括疼痛治疗、抗药性抑郁症和重症监护室(ICU)中的镇静剂。虽然氯胺酮一般耐受性良好,但长期大剂量使用会引起对潜在毒性的担忧,尤其是对肝脏的毒性。我们介绍了一例病史复杂的 27 岁女性患者的病例,她在接受氯胺酮输注用于重症监护室镇静时,肝功能检测(LFT)突然升高,表明可能存在氯胺酮诱导的肝损伤(KILI)。停用氯胺酮后,患者的肝功能恢复正常。KILI在短期使用氯胺酮的情况下并不常见,但新出现的病例报告表明,它可能与长期或间歇性接触氯胺酮有关。KILI 的基本机制尚未完全明了,但可能涉及氯胺酮代谢物的积累,从而对肝脏造成直接毒性影响。随着氯胺酮使用范围的扩大,尤其是在重症监护环境中的使用,临床医生应警惕 KILI 的潜在发展。需要进一步开展研究以更好地了解其风险因素和机制,因为早期发现和处理 KILI 对于确保患者安全和优化氯胺酮的治疗效果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Case Reports in Critical Care
Case Reports in Critical Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
2.10
自引率
0.00%
发文量
26
审稿时长
12 weeks
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