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Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity

The use of ketamine in patients with TBI has often been argued due to its possible deleterious effects on cerebral circulation and perfusion. Early studies suggested that ketamine could increase intracranial pressure, decreasing cerebral perfusion pressure and thereby reducing oxygen supply to the d...

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Autores principales: Zanza, Christian, Piccolella, Fabio, Racca, Fabrizio, Romenskaya, Tatsiana, Longhitano, Yaroslava, Franceschi, Francesco, Savioli, Gabriele, Bertozzi, Giuseppe, De Simone, Stefania, Cipolloni, Luigi, La Russa, Raffaele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949520/
https://www.ncbi.nlm.nih.gov/pubmed/35327044
http://dx.doi.org/10.3390/healthcare10030566
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author Zanza, Christian
Piccolella, Fabio
Racca, Fabrizio
Romenskaya, Tatsiana
Longhitano, Yaroslava
Franceschi, Francesco
Savioli, Gabriele
Bertozzi, Giuseppe
De Simone, Stefania
Cipolloni, Luigi
La Russa, Raffaele
author_facet Zanza, Christian
Piccolella, Fabio
Racca, Fabrizio
Romenskaya, Tatsiana
Longhitano, Yaroslava
Franceschi, Francesco
Savioli, Gabriele
Bertozzi, Giuseppe
De Simone, Stefania
Cipolloni, Luigi
La Russa, Raffaele
author_sort Zanza, Christian
collection PubMed
description The use of ketamine in patients with TBI has often been argued due to its possible deleterious effects on cerebral circulation and perfusion. Early studies suggested that ketamine could increase intracranial pressure, decreasing cerebral perfusion pressure and thereby reducing oxygen supply to the damaged cerebral cortex. Some recent studies have refuted these conclusions relating to the role of ketamine, especially in patients with TBI, showing that ketamine should be the first-choice drug in this type of patient at induction. Our narrative review collects evidence on ketamine’s use in patients with TBI. Databases were examined for studies in which ketamine had been used in acute traumatic brain injury (TBI). The outcomes considered in this narrative review were: mortality of patients with TBI; impact on intracranial pressure and cerebral perfusion pressure; blood pressure and heart rate values; depolarization rate; and preserved neurological functions. 11 recent studies passed inclusion and exclusion criteria and were included in this review. Despite all the benefits reported in the literature, the use of ketamine in patients with brain injury still appears to be limited. A slight increase in intracranial pressure was found in only two studies, while two smaller studies showed a reduction in intracranial pressure after ketamine administration. There was no evidence of harm from the ketamine’s use in patients with TBI.
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spelling pubmed-89495202022-03-26 Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity Zanza, Christian Piccolella, Fabio Racca, Fabrizio Romenskaya, Tatsiana Longhitano, Yaroslava Franceschi, Francesco Savioli, Gabriele Bertozzi, Giuseppe De Simone, Stefania Cipolloni, Luigi La Russa, Raffaele Healthcare (Basel) Review The use of ketamine in patients with TBI has often been argued due to its possible deleterious effects on cerebral circulation and perfusion. Early studies suggested that ketamine could increase intracranial pressure, decreasing cerebral perfusion pressure and thereby reducing oxygen supply to the damaged cerebral cortex. Some recent studies have refuted these conclusions relating to the role of ketamine, especially in patients with TBI, showing that ketamine should be the first-choice drug in this type of patient at induction. Our narrative review collects evidence on ketamine’s use in patients with TBI. Databases were examined for studies in which ketamine had been used in acute traumatic brain injury (TBI). The outcomes considered in this narrative review were: mortality of patients with TBI; impact on intracranial pressure and cerebral perfusion pressure; blood pressure and heart rate values; depolarization rate; and preserved neurological functions. 11 recent studies passed inclusion and exclusion criteria and were included in this review. Despite all the benefits reported in the literature, the use of ketamine in patients with brain injury still appears to be limited. A slight increase in intracranial pressure was found in only two studies, while two smaller studies showed a reduction in intracranial pressure after ketamine administration. There was no evidence of harm from the ketamine’s use in patients with TBI. MDPI 2022-03-17 /pmc/articles/PMC8949520/ /pubmed/35327044 http://dx.doi.org/10.3390/healthcare10030566 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Zanza, Christian
Piccolella, Fabio
Racca, Fabrizio
Romenskaya, Tatsiana
Longhitano, Yaroslava
Franceschi, Francesco
Savioli, Gabriele
Bertozzi, Giuseppe
De Simone, Stefania
Cipolloni, Luigi
La Russa, Raffaele
Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity
title Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity
title_full Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity
title_fullStr Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity
title_full_unstemmed Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity
title_short Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity
title_sort ketamine in acute brain injury: current opinion following cerebral circulation and electrical activity
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949520/
https://www.ncbi.nlm.nih.gov/pubmed/35327044
http://dx.doi.org/10.3390/healthcare10030566
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