Maia Mary Lucy Ferraz, Pantoja Lucas Villar Pedrosa Silva, Da Conceição Brenda Costa, Machado-Ferraro Kissila Márvia, Gonçalves Jackeline Kerlice Mata, Dos Santos-Filho Paulo Monteiro, Lima Rafael Rodrigues, Fontes-Junior Enéas Andrade, Maia Cristiane Socorro Ferraz
Laboratory of Pharmacology of Inflammation and Behavior, Faculty of Pharmacy, Institute of Health Science, Federal University of Pará, Belém 66075-900, Pará, Brazil.
Laboratory of Functional and Structural Biology, Biological Science Institute, Federal University of Pará, Belém 66075-110, Pará, Brazil.
J Clin Med. 2023 Jul 12;12(14):4643. doi: 10.3390/jcm12144643.
The developing central nervous system is vulnerable to several stimuli, especially psychotropic drugs. Sedation procedures during the developmental period are frequent in pediatric intensive care units (PICUs), in which the use of the sedative agent is still a challenge for the PICU team. Ketamine has been indicated for sedation in critically ill children with hemodynamic and ventilatory instabilities, but the possible neurobehavioral consequences related to this use are still uncertain. Here, we performed a bibliometric analysis with conventional metrics and a critical review of clinical findings to reveal a gap in the literature that deserves further investigation. We revealed that only 56 articles corresponded to the inclusion criteria of the study. The United States of America emerges as the main country within the scope of this review. In addition, professional clinical societies play a key role in the publications of scientific clinical findings through the specialist journals, which encourages the sharing of research work. The co-occurrence of keywords evidenced that the terms "sedation", "ketamine", and "pediatric" were the most frequent. Case series and review articles were the most prevalent study design. In the critical evaluation, the scarce studies highlight the need of use and post-use monitoring, which reinforces the importance of additional robust clinical studies to characterize the possible adverse effects resulting from ketamine anesthetic protocol in critically ill children.
发育中的中枢神经系统易受多种刺激影响，尤其是精神药物。在儿科重症监护病房（PICUs）中，发育期间的镇静程序很常见，而镇静剂的使用对PICU团队来说仍是一项挑战。氯胺酮已被用于血流动力学和通气不稳定的危重症儿童的镇静，但这种使用可能产生的神经行为后果仍不确定。在此，我们使用传统指标进行了文献计量分析，并对临床研究结果进行了批判性综述，以揭示文献中的一个空白，该空白值得进一步研究。我们发现只有56篇文章符合该研究的纳入标准。在本次综述范围内，美国是主要国家。此外，专业临床学会通过专业期刊在科学临床研究结果的发表中发挥关键作用，这鼓励了研究工作的分享。关键词共现表明，“镇静”“氯胺酮”和“儿科”这几个词出现频率最高。病例系列和综述文章是最普遍的研究设计。在批判性评估中，为数不多的研究强调了使用和使用后监测的必要性，这强化了开展更多有力临床研究以明确氯胺酮麻醉方案在危重症儿童中可能产生的不良反应的重要性。
