Use of ketamine to wean a patient with sleep apnea

An obese patient with sleep apnea and chronic obstructive pulmonary disease was difficult to sedate and ventilate after tracheostomy. High peak inspiratory pressures and severe patient agitation persisted despite sedation with lorazepam, and threatened security of the tracheostomy. The use of a ketamine infusion sedated the patient and allowed weaning to progress uneventfully.