UMEM Educational Pearls

Category: Pediatrics

Title: Ketamine and RSI for pts p TBI

Keywords: Ketamine, RSI, TBI (PubMed Search)

Posted: 1/18/2008 by Sean Fox, MD (Updated: 10/18/2019)
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Ketamine and RSI for pts p TBI

  • Traditionally, Ketamine has been avoided for patients with traumatic brain injury; however, this may be unwarranted…
    • Early after TBI, ICP is not usually elevated.
    • Early after TBI there is a low blood flow state, and Ketamine can increase cerebral blood flow.
    • As long as there is no obstruction to CSF flow, Ketamine will not increase ICP.
  • Evidence now states that Ketamine can be neuroprotective because it blocks glutamine because of it NMDA antagonist properties.
  • Ketamine also has antiepileptic properties (which improve pediatric TBI outcomes).
  • End result, if a patient has TBI and there is no concern for obstruction to CSF drainage, then Ketamine can be a possible option for RSI.