The effect of etomidate on intracranial pressure and systemic blood pressure in pediatric patients with severe traumatic brain injury
The effect of etomidate on intracranial pressure and systemic blood pressure in pediatric patients with severe traumatic brain injury
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DOI：
10.1097/01.pec.0000199563.64264.3a
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发表时间：
2006-02-01
影响因子：
1.4
通讯作者：
Witte, M
中科院分区：
文献类型：
--
作者：
Bramwell, KJ;Haizlip, J;Witte, M
目的：评价依托咪酯单次给药对重型颅脑损伤后颅内压增高患儿的疗效。方法：经监护人知情同意，入组重型颅脑损伤患儿重症监护室。实验干预是静脉注射依托咪酯0.3 mg/kg。仅当入组患者颅内压（ICP）急性升高至20 mm Hg以上并持续5分钟以上时，才给予该剂量。连续监测ICP和平均动脉压（MAP）。依托咪酯给药后连续6个5分钟间隔的ICP和MAP值的平均值为所有患者，并与基线比较。依托咪酯给药后平均ICP每5分钟均显著低于基线ICP（P < 0.05）。所有患者的平均MAP在前5分钟间隔内均较基线升高，但该变化无统计学显著性。没有病人的MAP下降低于基线在任何时间point.Conclusions：在严重创伤性脑损伤的儿科患者，单剂量依托咪酯给药导致在统计学上显着降低ICP和改善脑灌注压，而不显着改变MAP。
Objective: To evaluate the effects of single-dose etomidate in pediatric patients with intracranial hypertension after severe traumatic brain injury.Methods: Patients admitted to the pediatric intensive care unit with severe traumatic brain injury were enrolled with the informed consent of their guardians. The experimental intervention was a single dose of etomidate 0.3 mg/kg intravenously. This dosage was administered only when enrolled patients had acute elevations of intracranial pressure (ICP) to over 20 mm Hg for over 5 minutes. ICP and mean arterial pressure (MAP) were monitored continuously. ICP and MAP values for 6 consecutive 5-minute intervals after etomidate administration were averaged for all patients and compared with baseline.Results: Eight patients were enrolled. Mean ICP after etomidate administration was significantly lower than baseline ICP for each 5-minute interval (P < 0.05). The mean MAP for all patients increased from baseline during the first 5-minute interval, but this change was not statistically significant. No patient's MAP decreased below baseline at any time point.Conclusions: In pediatric patients with severe traumatic brain injury, single-dose etomidate administration resulted in statistically significant reductions in ICP and improvement in cerebral perfusion pressure without significantly altering MAP.