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.