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 | ||