Association between simulated ketamine exposures and oxygen saturations in children.



We performed a real-world data analysis to evaluate the relationship between simulated ketamine exposures and oxygen desaturation in children.

Materials & methods

A previously developed population pharmacokinetic model was used to simulate exposures and evaluate target attainment, as well as the association with oxygen desaturation in children ≤17 years treated with intravenous ketamine.


In 2022 children, there was no significant association between simulated plasma ketamine concentrations and oxygen saturation; however, a higher cumulative area under the curve was associated with increased odds of progression to significant desaturation (<85%), though magnitude of effect was small.


By leveraging a population pharmacokinetic model and real-world data, we confirmed there is no relationship between simulated ketamine plasma concentration and oxygen desaturation.





Published Version (Please cite this version)


Publication Info

Commander, Sarah Jane, Daniel Gonzalez, Karan R Kumar, Tracy Spears, Michael Cohen-Wolkowiez, Kanecia O Zimmerman, Jan Hau Lee, Christoph P Hornik, et al. (2023). Association between simulated ketamine exposures and oxygen saturations in children. International journal of pharmacokinetics, 6(1). p. IPK03. 10.4155/ipk-2022-0003 Retrieved from

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Daniel Gonzalez

Associate Professor in Medicine

Dr. Daniel Gonzalez is an Associate Professor in the Division of Clinical Pharmacology of the Department of Medicine at the Duke University School of Medicine, and a member of the Duke Clinical Research Institute. Gonzalez received his PharmD and PhD from the University of Florida College of Pharmacy in 2008 and 2012, respectively. He then completed a postdoctoral fellowship through the UNC-Duke Collaborative Clinical Pharmacology T32 Postdoctoral Training Program. Following completion of his post-doctoral training, Gonzalez served as a faculty member at the UNC Eshelman School of Pharmacy between 2014 and 2023 and moved to Duke University in 2023. 

Gonzalez’s experiences have afforded a highly collaborative and multidisciplinary research program focused on advancing public health by promoting the safe, effective, and individualized use of drugs, with an emphasis on pediatric populations. His research interests include clinical pharmacology and applying mathematical modeling and simulation techniques to characterize the pharmacokinetics and pharmacodynamics of drugs, guide drug dosage selection, and improve drug safety. Gonzalez’s research program is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and he has published >110 peer-reviewed publications and >40 abstracts. He has been the major advisor for 8 PhD students (4 completed, 4 in training) and 15 postdoctoral fellows.


Karan Ravindra Kumar

Assistant Professor of Pediatrics

I am an Assistant Professor of Pediatrics and a Pediatric Critical Care Physician at Duke University School of Medicine, and I am also affiliated with the Duke Clinical Research Institute (DCRI). My research focuses on advancing pediatric healthcare through the integration of biostatistics, clinical research informatics, and data science. I have significant experience managing large datasets, including the Pediatrix Medical Group Clinical Data Warehouse and the NICHD-funded Pediatric Trials Network, which have provided vital insights into disease patterns and pediatric drug labeling. I contribute analytical support to various pediatric research initiatives. My efforts extend to exploring automation of data integration in clinical trials, enhancing research infrastructure, and leading critical trials and registries to improve pediatric health outcomes. I am enthusiastic about applying my expertise in biostatistics, database management, and predictive analytics to future projects.

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