- Version
- Download 7
- File Size 429.00 KB
- File Count 1
- Create Date November 16, 2023
- Last Updated November 16, 2023
| File | |
|---|---|
| Spreading depolarization in acute brain injury inhibited by ketamine: a prospective, randomized, multiple crossover trial |
Spreading depolarization in acute brain injury inhibited by ketamine: a prospective, randomized, multiple crossover trial
Andrew P Carlson, Mohammad Abbas, Robert L Alunday, Fares Qeadan, C William Shuttleworth
Abstract
OBJECTIVE: Retrospective clinical data and case studies support a therapeutic effect of ketamine in suppression of spreading depolarization (SD) following brain injury. Preclinical data strongly support efficacy in terms of frequency of SD as well as recovery from electrocorticography (ECoG) depression. The authors present the results of the first prospective controlled clinical trial testing the role of ketamine used for clinical sedation on occurrence of SD.
METHODS: Ten patients with severe traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (SAH) were recruited for this pilot trial. A standard ECoG strip was placed at the time of craniotomy, and the patients were then placed on an alternating every-6-hour schedule of ketamine or other sedation agent. The order of treatment was randomized. The ketamine dose was adjusted to clinical effect or maintained at a subanesthetic basal dose (0.1 mg/kg/hr) if no sedation was required. SD was scored using standard criteria, blinded to ketamine dosing. Occurrence of SD was compared with the hourly dose of ketamine to determine the effect of ketamine on SD occurrence.
