July 6, 2023

Benefits of ketamine in children with TBI explored

A common anesthesia drug could be beneficial in reducing pressure inside the skull of children with traumatic brain injuries (TBI), according to a study published in Critical Care Medicine.

Ketamine, a drug used for anesthesia since the 1970s, has traditionally been avoided for patients with TBI due to early studies suggesting that it could raise the pressure inside of the skull, known as intracranial pressure (ICP).

More recent studies suggest otherwise, said lead author Michael Wolf, MD, assistant professor of Pediatrics and Neurological Surgery and director of Neuro- critical Care at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

Wolf and his co-authors reexamined the effects of ketamine on ICP in children admitted to the pediatric intensive care unit with severe TBI, analyzing data from 33 patients ages 1 month to 16 years, 22 of whom received ketamine as part of a treatment protocol informed by evidence-based guidelines.

Eighteen ketamine doses were given during ICP crises in 11 patients, and an overall decrease in ICP was observed.

Wolf said the results are “exciting,” and he hopes a larger study repeats the findings.