Anesthesiologist and Intensivist Neuroscience, Dokuz Eylül University Faculty of Medicine Department of Anesthesiology and Reanimation, Subdivision of Critical Care Medicine, İzmir, Turkey.
Anesthesiologist and Intensivist, Dokuz Eylül University Faculty of Medicine Department of Anesthesiology and Reanimation, Subdivision of Critical Care Medicine, İzmir, Turkey.
Medicine (Baltimore). 2024 May 17;103(20):e38172. doi: 10.1097/MD.0000000000038172.
This study aims to investigate the effect of amantadine use on neurological outcomes and mortality in patients with severe traumatic brain injury (TBI) (Glasgow coma score [GCS] between 3 and 8) who have been followed up on mechanical ventilators in the intensive care unit (ICU). Data from the hospital's electronic records were retrospectively searched. Patients over 18 years of age, with severe brain trauma (GCS between 3-8), who were treated with endotracheal intubation and invasive mechanical ventilation at admission to the ICU, and who were treated with Amantadine hydrochloride at least once in the first week of follow-up were included in the study. To evaluate the patients' neurological outcomes, the GCS and FOUR scores were used. GCS and FOUR scores were recorded on the 1st, 3rd, and 7th days of the first week. In addition, the score difference between the 1st and 7th day was calculated for both scores. The patients were divided into 2 groups: those receiving amantadine treatment (Group A, n = 44) and the control group (Group C, n = 47). The median age of all patients was 39 (18-81) (P = .425). When Group A and Group C were compared, no statistically significant results were found between the 1st, 3rd, and 7th day GCS values (P = .474, P = .483, and P = 329, respectively). However, the difference in GCS values between day 1 and day 7 (∆ GCS 7-1) was statistically significant (P = .012). Similarly, when Group A and Group C were compared, no statistically significant results were found between the 1st, 3rd, and 7th day FOUR score values (P = .948, P = .471, and P = .057, respectively). However, the FOUR score values between day 1 and day 7 (∆ FOUR score 7-1) were statistically significant (P = .004). There was no statistically significant difference among the groups in terms of ICU length of stay, duration of non-ICU hospital stay, and length of hospital stay (P = .222, P = .175, and P = .067, respectively). Amantadine hydrochloride may help improve neurological outcomes in patients with severe TBI. However, further research is needed to investigate this topic.
本研究旨在探讨盐酸金刚烷胺在重症创伤性脑损伤（TBI）（格拉斯哥昏迷评分[GCS]为 3 至 8 分）患者中的作用，这些患者在重症监护病房（ICU）中接受机械通气治疗。对医院电子病历进行回顾性搜索。纳入标准为：年龄超过 18 岁，GCS 为 3-8 分，入院时接受气管插管和有创机械通气治疗，在随访的第一周内至少使用过一次盐酸金刚烷胺。使用 GCS 和 FOUR 评分评估患者的神经功能预后。在第 1、3 和 7 天记录 GCS 和 FOUR 评分。此外，还计算了这两个评分的第 1 天和第 7 天之间的评分差值。患者分为两组：接受盐酸金刚烷胺治疗的患者（A 组，n=44）和对照组（C 组，n=47）。所有患者的中位年龄为 39 岁（18-81）（P=0.425）。比较 A 组和 C 组，第 1、3 和 7 天的 GCS 值无统计学差异（P=0.474、P=0.483 和 P=0.329）。然而，GCS 值在第 1 天和第 7 天之间的差异具有统计学意义（∆GCS 7-1，P=0.012）。同样，比较 A 组和 C 组，第 1、3 和 7 天的 FOUR 评分值无统计学差异（P=0.948、P=0.471 和 P=0.057）。然而，第 1 天和第 7 天之间的 FOUR 评分值具有统计学差异（∆FOUR 评分 7-1，P=0.004）。三组患者的 ICU 住院时间、非 ICU 住院时间和住院时间无统计学差异（P=0.222、P=0.175 和 P=0.067）。盐酸金刚烷胺可能有助于改善重症 TBI 患者的神经功能预后。然而，需要进一步研究来探讨这一主题。
