Use of Neuroprotective agents for Traumatic Brain Injury

M. Meshkini, A. Meshkini, H. Sadeghi-Bazargani
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Abstract

Traumatic brain injury (TBI) is the leading cause of mortality and morbidity especially in young ages, while over 30 years of neuroprotective agents use for TBI management provided neither any recommended agent for favorable outcome nor less adverse effects in TBI management yet. This review got selected keywords ’ search and ran in known international and local databases, with no limitation up to September 6, 2015. Related to the subject, clinical human studies have been selected for the review. Data from 32 studies were classified into 10 subgroups. About 18 studies with a population of 4637 participants were included in 6 topic reviews and meta-analyses. Oxygen use in acute management of TBI to reduce mortality rates could be recommended. Corticosteroid use in solo acute TBI management is prohibited due to increasing risk of mortalities. However, in dual-diagnosed patients (TBI and spinal cord injury (SCI) together), corticosteroid use should be obtained by a Bracken protocol. The use of citicoline in acute TBI is no more supported. The use of cyclosporine-A for ICP control depends on the resources and physician ’ s decision. Rivastigmine use for chronic neurocognitive conditions of TBI management had some beneficence in severely impaired participants. However, the use of other agents in TBI has no field of support yet.
神经保护剂在创伤性脑损伤中的应用
创伤性脑损伤(TBI)是死亡率和发病率的主要原因,特别是在年轻人中,而30多年来用于TBI治疗的神经保护剂既没有提供任何推荐的TBI治疗的有利结果,也没有提供更少的不良反应。本综述选取关键词进行检索,在国际、国内知名数据库中运行,截止到2015年9月6日不受限制。与该主题相关的临床人体研究已被选中进行审查。32项研究的数据被分为10个亚组。6项主题综述和荟萃分析纳入了18项研究,共4637名参与者。建议在创伤性脑损伤的急性治疗中使用氧气以降低死亡率。由于死亡风险增加,禁止单独使用皮质类固醇治疗急性脑外伤。然而,在双重诊断的患者(TBI和脊髓损伤(SCI)一起)中,皮质类固醇的使用应按照Bracken方案进行。在急性TBI中使用胞胆碱不再被支持。使用环孢素a控制ICP取决于资源和医生的决定。使用利瓦斯汀治疗TBI慢性神经认知疾病对严重受损的参与者有一定的益处。然而,在TBI中使用其他药物还没有得到支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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