Fuller BM, et al. - By analyzing existing literature, researchers quantified the influence of ketamine in mechanically ventilated patients in a systematic review and meta-analysis. They explored EMBASE, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, conference proceedings, and reference lists to identify relevant randomized and nonrandomized studies. They analyzed 15 studies (n = 892 patients). They found the link of ketamine with a decrease in propofol infusion rate in random effects meta-analytic models, with no effect of ketamine evident on fentanyl or midazolam. No link of ketamine with mortality, on-target sedation, vasopressor dependence, or hospital length of stay was revealed. Most frequent were cardiovascular complications (eg, tachycardia and hypertension), followed by neurocognitive events. They found that there exists limited data about ketamine use in mechanically ventilated patients as far as quantity and methodological quality are concerned. The data showed a clinical benefit. A possible role of ketamine as a sedative-sparing agent was suggested, with its possible link with harm.