UMEM Educational Pearls

Title: Intubating the brain injured patient

Category: Trauma

Keywords: brain injury, evidence, eucapnia, normotensive, care (PubMed Search)

Posted: 10/25/2025 by Robert Flint, MD (Updated: 10/26/2025)
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Another paper emphasizing care for brain injured patients should include:

-pre-intubation preoxygenation to avoid hypoxia

-pre-intubation avoid extremes in blood pressure (hypotension kills)

-use hemodynamically neutral induction agents such as ketamine or etomidate

-post intubation target eucapnia on the ventilator. (do not aim for low CO2)

-post intubation maintain adequate sedation to avoid increased intercranial pressure

References

Hoyne J, Edlow J. Airway Management in Patients With Acute Brain Injury or Ischemia. J Emerg Med. 2025 Jul;74:125-133. doi: 10.1016/j.jemermed.2024.12.015. Epub 2025 Jan 6. PMID: 40348691.