Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
A Short Question: Can Amantadine Sulfate İnfusion be a Life Saver in ICU?
Kısa Bir Soru: Amantadin Sülfat İnfüzyonu Yoğun Bakım Ünitesinde Hayat Kurtarıcı Olur mu?
Ece SALİHOĞLUa, Ayça Sultan ŞAHİNb
aDepartment of Pediatric Cardiac Surgery, Istanbul Science University,
bDepartment of Anaesthesiology and Reanimation, SBU Kanuni Sultan Suleyman Education
and Training Hospital, İstanbul
Turkiye Klinikleri J Med Sci. 2019;39(2):129-34
doi: 10.5336/medsci.2018-62457
Article Language: EN
Full Text
ABSTRACT
 Background: Traumatic brain injury (TBI) is one of the leading causes that cognitive and behavioral problems. Many pharmacological therapies reveal early neurochemical changes. The CRS-R is a standardized neuro-behavioral evaluation tool comprising six organized subscales (auditory, visual, motor, oromotor-verbal, communication, and arousal). We hypothesized that, the effect of amantadine sulfate infusion treatment on conscious recovery and clinical improvement in patients with severe head injury in terms of CRS-R and clinical recovery. Methods: Patients' age, gender, days of hospitalization, pre-treatment and post-treatment GCS, education level, day of amantadine sulfate, intubated or non-intubated when he/she come to ICU, recovery time of conscious, discharge time, CT or MR pathology will be retrospectively recorded. Patients were aged >18, had brain trauma, had amantadine sulfate therapy in ICU were included the study between June 2016-June 2017. Results: A total of 40 patients using amantadine sulfate infusion were included in the study. It was determined that 13 of patients had mortality. Improvement in CT and MRI findings were detected in 21 of the living patients (77.8%). There were no differences between the mean starting time according to the clinical recovery levels and recovery status on CT-MRI. There were statistically significant differences between starting time and time of extubation and starting time of consciousness recovery and discharge time. Conclusion: In conclusion, we believe that amantadine treatment accelerates neurological recovery in terms of CRS-R and clinical recovery in TBI patients.

Keywords: Amantadine sulfate; cerebral injury; traumatic brain injury
ÖZET
 Amaç: Travmatik beyin hasarı (TBH), bilişsel ve davranışsal sorunların önde gelen nedenlerinden biridir. Birçok farmakolojik tedavi erken nörokimyasal değişiklikleri açıklamaktadır. CRS-R, altı organize alt ölçek (işitsel, görsel, motor, oromotor-sözel, iletişim ve uyarılma) içeren standartlaştırılmış bir nöro davranışsal değerlendirme aracıdır. Biz CRS-R ve klinik iyileşme açısından ağır kafa travmalı hastalarda amantadin sülfat infüzyon tedavisinin bilinç düzeyinde ve klinik iyileşme üzerindeki etkisini sunmayı amaçladık. Gereç ve Yöntem: Hastaların yaşı, cinsiyeti, hastanede yatış günleri, tedavi öncesi ve tedavi sonrası GKS, eğitim düzeyi, amantadin sülfat günü, entübe gelip gelmediği, bilinçte düzelme zamanı, taburculuk süresi, BT veya MR patolojileri retrospektif olarak kaydedildi. Haziran-Haziran 2017 tarihleri arasında 18 yaş üstü, beyin travması geçiren, yoğun bakımda amantadin sülfat tedavisi alan hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya amantadin sülfat infüzyonu kullanan toplam 40 hasta dahil edildi. Hastaların 13'ünde mortalite olduğu tespit edildi. Yaşayan hastaların 21'inde (% 77.8) BT ve MR bulgularında iyileşme saptandı. Klinik iyileşme düzeylerine ve BT-MR'da iyileşme durumuna göre ortalama başlangıç zamanı arasında fark yoktu. Başlangıç zamanı ve ekstübasyon zamanı ile bilincin düzelme ve taburculuk süresinin zamanı arasında istatistik olarak anlamlı fark gözlendi. Tartışma: Sonuç olarak, amantadin sülfat tedavisinin, CRS-R açısından da değerlendirildiğinde TBH hastalarında klinik iyileşme ve nörolojik iyileşmeyi hızlandırdığını düşünüyoruz.

Anahtar Kelimeler: Amantadin sülfat; serebral yaralanma; travmatik beyin hasarı
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