The Role of Ketamine as an Adjuvant Therapy for Children With Acute Status Asthmaticus

Inclusion Criteria:

* Pediatric patients (≥2 years and ≤ 18 years old)

Patients presenting in status asthmaticus:

* Patients with a CAS of greater than or equal to 10 on presentation that have received at least two (appropriately dosed based on weight) albuterol treatments prior to arrival

OR

* Patients with a CAS of greater than or equal to 10 that have not received treatment prior to arrival and after 1 hour of treatment per the severe asthma pathway do not have a decrease in CAS of greater than 2

OR

* Patients with a CAS above 6 but less than 10 as measured 1 hour after initiation of standard treatment per AU's moderate asthma pathway

Exclusion Criteria:

* Pregnancy
* Congestive Heart Failure or prior diagnosis of cardiovascular disease (congenital or acquired)
* Chronic lung disease outside of a previous diagnosis of Asthma
* Seizure disorder
* Liver disease
* History of hypertension greater than 95% for age
* Obstructive Sleep Apnea with AHI greater than 5
* History of allergic or serious reaction to Ketamine
* Significant history of psychiatric illness defined as any patient with a diagnosis of psychiatric illness meeting the Diagnostic and Statistical Manual of Mental Disorders V criteria (severe Autism)