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Table 1 Ketamine in severe TBI

From: Ketamine in acute phase of severe traumatic brain injury “an old drug for new uses?”

Author Year Population Number Study Doses ICP response CPP response Adverse effects
Bar Joseph et al. 2009 Adult Mechanical ventilated Severe TBI N = 25 Prospective
Group A: normal ICP
Group B: high ICP
Bolus 1–1.5 mg/kg Group A: No increase
Group B: Decrease 32% (Mean 25.7 to 17.6 mmHg)
NA None
Bar Joseph et al. 2009 Pediatric mechanical ventilated severe TBI N = 30 Prospective
Group 1: ketamine prevention
Group B: ketamine to reduce ICP
Bolus 1–1.5 mg/kg Group A: ICP decrease
(Mean 25.2 to 17.9 mmHg)
Group B: ICP decrease
(Mean 26 to 17.5 mmHg)
Group A and Group B: CPP increase None
Boirgoin et al. 2005 Adult mechanical ventilated severe TBI N = 30 Prospective
Group 1: sufentanyl + Midazolam
Group 2: ketamine + midazolam
Continuous infusión to achieve plasma concentration of 1 mcg/ml No difference in ICP
ICP non increase (non reported values)
No difference None
Boirgoin et al. 2003 Adult mechanical ventilated severe TBI N = 25 Prospective
Group 1: ketamine + Midazolam
Group 2: Midazolam + sufentanyl
Continuous infusión 82 mcg/kg/min No difference between groups (Mean 19 vs 15.7 mmHg-p = 0.28) NA Non significant increase in HR
Albanese et al. 1997 Adult mechanical ventilated severe TBI N = 8 Prospective Bolus 1.5; 3; and 5 mg/kg ICP decrease from baseline at all doses (Mean 2, 4 and 5 mmHg at 1,5; 3 and 5 mg/kg, respectively) NA None
Kolenda et al. 1996 Adult mechanical ventilated moderate and severe TBI N = 24 Prospective Group 1: ketamine + Midazolam
Group 2: fentanyl + midazolam
Continuous infusión 104 mg/kg/day ICP 2 mmHg higher in ketamine group only at day 8 of infusion CPP 8 mmHg higher in ketamine group None
Schmitter et al. 2007 Adult mechanical ventilated severe TBI N = 24 Prospective
Group 1: fentanyl + methohexitone
Group 2: ketamine + methohexitone
Continuous infusión 2 mg/kg/h No difference between groups
Mean 15.9 vs 14.7 mmHg)
No difference between groups None