Using Etomidate to Lower Intracranial Pressure in Children

A small case series adds to the growing — but still incomplete — evidence supporting this treatment.

Improved outcome after traumatic brain injury depends on the prevention of hypotension and intracranial hypertension, and the maintenance of adequate cerebral perfusion pressure (CPP). In adults, the sedative etomidate has been shown to reduce intracranial pressure (ICP) and improve CPP. In a small case series, researchers examined the effect of a single dose of etomidate on ICP and mean arterial pressure (MAP) in children.

The patients were eight severely brain-injured children, all younger than 15, who had an ICP monitor and indwelling arterial catheter and were sedated, paralyzed, and ventilated. Patients were given 0.3 mg/kg of etomidate after their ICP exceeded 20 mm Hg for more than 5 minutes. ICP, MAP, and CPP were monitored every min…

Reviewing Author

Jill M. Baren, MD, FACEP