In this retrospective, exploratory study, intracranial pressure (ICP) did not increase following ketamine administration. In the setting of a guidelines-based protocol, ketamine was associated with a reduction in ICP during ICP crises. If these findings are reproduced in a larger study, ketamine may warrant consideration as a treatment for intracranial hypertension in children with severe traumatic brain injury (TBI).

We analyzed data from 33 patients, ages 1 month to 16 years, 22 of whom received bolus doses of ketamine, with 127 doses analyzed. Demographics, patient, and injury characteristics were similar between patients who did versus did not receive ketamine boluses.

In analysis of the subset of ketamine doses used only for sedation, there was no significant difference in ICP or CPP from baseline.

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