Ketamine Is Safe in Children with Elevated Intracranial Pressure

Ketamine decreased intracranial pressure and increased cerebral perfusion pressure in intubated children with intracranial hypertension.

Ketamine is a unique sedation or induction agent for intubation because it supports blood pressure and does not impair ventilation. On the basis of anecdotal claims of increased intracranial pressure (ICP) and fears of decreased cerebral perfusion pressure (CPP), many clinicians have considered ketamine to be contraindicated in patients with intracranial hypertension. Investigators evaluated the effects of ketamine sedation on ICP and CPP in 30 children (age range, 1–16 years) with elevated ICP who received ketamine (1.0–1.5 mg/kg) before 82 potentially distressing procedures at an Israeli neurosurgical intensive care unit.

All patients were mechanically ventilated and sedated with benzodiazepines, barbiturates, or propofol, and all had ICP …

Reviewing Author

Daniel J. Pallin, MD, MPH