(Press-News.org) A common anesthesia drug could be beneficial in reducing pressure inside the skull of children with traumatic brain injuries (TBI), according to a study published in Critical Care Medicine.
Ketamine, a drug that has been used for anesthesia since the 1970s, has traditionally been avoided for patients with TBI due to early studies suggesting that it could raise the pressure inside of the skull, known as intracranial pressure (ICP).
More recent studies have suggested otherwise, said lead author Michael Wolf, MD, assistant professor of Pediatrics and Neurological Surgery and director of Neurocritical Care at Monroe Carell Jr. Children’s Hospital at Vanderbilt.
Wolf and his co-authors set out to reexamine the effects of ketamine on ICP in children admitted to the pediatric intensive care unit (PICU) with severe TBI, analyzing data from 33 patients ages 1 month to 16 years, 22 of whom received ketamine as part of a treatment protocol informed by evidence-based guidelines.
Eighteen ketamine doses were given during ICP crises in 11 patients, and an overall decrease in ICP was observed.
“We found that not only does ketamine not raise ICP, in some cases it may even lower it,” Wolf said. “Children with severe TBI are at risk of dying or having long-term neurologic impairment, such as difficulty walking and talking. In the crucial days following their initial injury, our focus in the PICU is to minimize ongoing damage to their brains, with a focus on preventing and treating high ICP.”
“Despite decades of research, our treatment options remain limited to a handful of medicines and techniques,” he added. “This study might help open the door to a new use of an old drug that could help us continue to improve our approach to caring for these vulnerable children.”
Wolf said study the results are “exciting, though preliminary” because ketamine was associated with a reduction in ICP during ICP crises. If the findings are reproduced in a larger study, ketamine may warrant consideration as a treatment for intracranial hypertension in children with severe TBI, he said.
“Going forward, we plan to study the effects of ketamine in larger numbers of children with traumatic brain injury, partnering with colleagues at other children’s hospitals to do so,” Wolf said. “If we are able to improve our understanding of ketamine’s effects in a larger study, we might find that ketamine represents another tool to provide the best possible treatment for children with traumatic brain injury.”
The study results could reverse nearly two decades of thinking related to ketamine and intracranial pressure, according to co-author John C. “Jay” Wellons, III, MD, MSPH, Cal Turner Chair and chief of Pediatric Neurosurgery at Monroe Carell.
“This is a terrific example of what the pediatric neurocritical care effort is capable of,” Wellons said. “Dr. Wolf and his pediatric ICU colleagues not only provide excellent care, but also conduct field-impacting clinical research.
“This study alone represents a near complete reversal in how we think about the relationship between ketamine and intracranial pressure. The results will likely lead to further studies that I believe will change 20 years of past thinking,” he said.
Study shows ketamine could be beneficial for treating brain injury in children
ELSE PRESS RELEASES FROM THIS DATE:
Yak milk consumption among Mongol Empire elites
Photos For the first time, researchers have pinpointed a date when elite Mongol Empire people were drinking yak milk, according to a study co-led by a University of Michigan researcher. By analyzing proteins found within ancient dental calculus, an international team of researchers provides direct evidence for consumption of milk from multiple ruminants, including yak. In addition, they discovered milk and blood proteins associated with both horses and ruminants. The team's results are published in Communication Biology. The study presents novel protein findings from an elite Mongol Era cemetery ...
Hope for salamanders? Illinois study recalibrates climate change effects
URBANA, Ill. – For tiny salamanders squirming skin-to-soil, big-picture weather patterns may seem as far away as outer space. But for decades, scientists have mostly relied on free-air temperature data at large spatial scales to predict future salamander distributions under climate change. The outlook was dire for the mini ecosystem engineers, suggesting near elimination of habitat in crucial areas. Now, University of Illinois researchers are tuning into the microclimates that really matter to the imperiled amphibians and forecasting a somewhat more hopeful future. “The ...
Engineered E. coli delivers therapeutic nanobodies to the gut
BOSTON-- Humans are colonized with thousands of bacterial strains. Researchers are now focused on genetically modifying such bacteria to enhance their intrinsic therapeutic properties. One goal is to develop smart microbes that release therapeutic payloads at sites of disease, thus maintaining therapeutic efficacy while limiting many of the side effects that can be associated with the systemic administration of conventional drugs. Investigators at Massachusetts General Hospital (MGH), a founding member of Mass General Brigham (MGB), have engineered a strain of the probiotic Escherichia ...
New type of friction discovered in ligand-protein systems
An interdisciplinary research team of the Institutes of Physical Chemistry and Physics of the University of Freiburg and the Max Planck Institute of Biophysics in Frankfurt-am-Main has discovered a new, direction-dependent friction in proteins called anisotropic friction. “Until now, nobody had observed that friction in biomolecules was dependent on direction,” says physicist Dr. Steffen Wolf of the University of Freiburg. The results have been published as cover story in the scientific journal “Nano Letters.” Experiments on model complex of protein-ligands Proteins constitute the microscopic machinery of cells. They perform work during their functional cycles. Accordingly, ...
New UNC Chapel Hill study quantifies $562M in financial risk from Hurricane Florence using novel modeling approach that evaluates risk of mortgage default and property abandonment
When Hurricane Florence made landfall on North Carolina’s coast in 2018, it brought record rainfall causing catastrophic flooding and damages to communities across the eastern portion of the state. Estimating the financial impacts of household flooding is complex because direct damages often snowball into other financial risks, like a decrease in property value or loss of equity. Generally, post-disaster damage assessments focus on insured and uninsured losses, but these numbers do not account for the secondary impacts to households, lenders, local governments and other stakeholders who may also share in the financial consequences if a property owner defaults ...
What is foreign exchange market or simply Forex?
The Forex market, also known as the foreign exchange market or simply Forex (short for "foreign exchange"), is a decentralized global market where various currencies are traded. It is the largest financial market in the world, with a daily trading volume exceeding $6 trillion. The primary purpose of the Forex market is to facilitate international trade and investment by allowing businesses, governments, and individuals to convert one currency into another.
Can cities make room for woodpeckers?
Researchers are deploying the latest mapping techniques to identify the most important suburban habitat for North America’s largest woodpecker. University of Cincinnati doctoral student Ruijia Hu said wildlife habitat in congested places like southwest Ohio is becoming increasingly fragmented as forests give way to new construction. Eventually, this could spell trouble to an animal with specific habitat needs like Ohio’s pileated woodpecker. Pileated woodpeckers are crow-sized birds with colorful red crests and striking white facial stripes. They are found in forests from British Columbia to Florida. They have the ...
Study: ChatGPT has potential to help cirrhosis, liver cancer patients
A new study by Cedars-Sinai investigators describes how ChatGPT, an artificial intelligence (AI) chatbot, may help improve health outcomes for patients with cirrhosis and liver cancer by providing easy-to-understand information about basic knowledge, lifestyle and treatments for these conditions. The findings, published in the peer-reviewed journal Clinical and Molecular Hepatology, highlights the AI system’s potential to play a role in clinical practice. “Patients with cirrhosis and/or liver cancer and their caregivers often have unmet needs and insufficient knowledge about managing and preventing complications of their disease,” ...
A healthy microbiome may prevent deadly infections in critically ill people
Twenty to 50 per cent of all critically ill patients contract potentially deadly infections during their stay in the intensive care unit or in hospital after being in the ICU – markedly increasing the risk of death. “Despite the use of antibiotics, hospital-acquired infections are a major clinical problem that persists to be a huge issue for which we don’t have good solutions,” says Dr. Braedon McDonald, MD, PhD, an intensive care physician at the Foothills Medical Centre (FMC) and assistant professor at the ...
Academic institutions receive lower financial returns from biotechnology licenses than commercial firms
BENTLEY UNIVERSITY The financial terms of biotechnology licenses from academic institutions are significantly less favorable than those of comparable licenses between commercial firms according to a new study from Bentley University’s Center for Integration of Science and Industry. The study, published in the journal PLOS ONE, shows that the royalties and payments to academic institutions are significantly lower than those to commercial firms for similar licenses and products at the same stages of development. The article, titled “Comparing the economic terms of biotechnology licenses from academic institutions with those ...