Amantadin İnfüzyonunun Travmatik Beyin Hasarında Etkisi

Öz

Amaç: Travmatik Beyin Hasarı (TBH), önemli bir sosyoekonomik ve halk sağlığı sorunudur. Amantadin sülfat nöroprotektif olarak kullanılan bir ilaçtır. Bu çalışmada, amantadin infüzyon tedavisinin, ciddi kafa travması olan hastalarda bilincin geri dönmesine pozitif etkisini araştırmayı amaçladık.
Materyal ve Metot: TBH olan hastalar, amantadin infüzyonu kullanma durumarına göre iki gruba ayrıldı. Grup I (n=40): amantadin infüzyonu kullanan grup ve Grup II (n=40): amantadin infüzyonu kullanmayan grup. Hastaların yaşları, cinsiyetleri, Glasgow Koma Skalası (GKS), eğitim seviyeleri, yoğun bakım ünitesine geldiğinde entübe olup olmadıkları, bilincin geri dönüş zamanı, taburculuk zamanı ve BT veya MR sonuçları ve Coma Recovery Scale–Revised (CRS-R) skoru retrospektif olarak kaydedildi.
Bulgular: Bilincin geri dönüş zamanı Grup I de istatistiksel olarak belirgin olarak daha kısaydı. Hastaların eğitim düzeyleri arasında istatistiksel olarak anlamlı bir fark saptanmadı. Grup I de hastaların yoğun bakıma kabulü sırasında GKS daha düşüktü. Fonksiyonel nesne kullanımı ve uzun dönemli dikkat Grup I de CRS-R’ye göre daha yüksekti.
Sonuç: Bu çalışmaya göre, amantadin infüzyonu nörolojik iyileşmeyi ve nörokognitif fonksiyonları olumlu yönde etkilemektedir.

Anahtar Kelimeler

• Hasar,Beyin,Amantadin infüzyonu,travmatik

Effect of Amantadine Infusion on Traumatic Brain Injury

Abstract

Objective: Traumatic brain injury (TBI) is a significant socioeconomic and public health problem. Amantadine sulfate has been used as a neuroprotective drug. In this study, We aim that amantadine infusion treatment effects positively in patients with a severe head injury on conscious recovery. 

Materials and Methods: Patients with TBI were classified into two groups: Patients that used amantadine infusion group was Group I (n=40) and patients that not used amantadine infusion group was Group group II (n=40). Age, gender, Glasgow Coma Scale (GCS), education level, intubated or non-intubated when he/she come to Intensive Care Unit (ICU), the recovery time of conscious, discharge time, recovery of CT or MR scan and Coma Recovery Scale-Revised (CRS-R) were retrospectively recorded. 

Results: Time to recovery in consciousness was statistically significant shorter in group I. There were no statistically significant differences between the educational status of patients. The GCS of patients, when admitted to ICU, was lower in group I. Functional object use and long-term attention were have higher scores in group I when compared to CRS-R.

Conclusion: Amantadine infusion affects positively neurological recovery and neurocognitive function for TBI in this study.

Keywords

• Amantadine ınfusion,brain,ınjury,traumatic

References

1. 1-Leone H, Polsonetti BW. Amantadine for traumatic brain injury: does it improve cognition and reduce agitation? Journal of Clinical Pharmacy and Therapeutics. 2005;30:101–104.
2. 2-Scott D, Spritzer DO, Kinney CL, et al. Amantadine for Patients With Severe Traumatic Brain Injury A Critically Appraised Topic. The Neurologist. 2015;19:61–64
3. 3-Gramish JA, Kopp BJ, Patanwala AE. Effect of Amantadine on Agitation in Critically Ill Patients With Traumatic Brain Injury. Clinical Neuropharmacology. 2017;5:212-216.
4. 4-Stelmaschuk S, Will MC, Meyers T. Amantadine to Treat Cognitive Dysfunction in Moderate to Severe Traumatic Brain Injury. J Trauma Nurs. 2015;22 (4):194-203.
5. 5-Saniova B, Drobny M, Kneslova L, Minorik M. The outcome of patients with severe head injuries treated with amantadine sulfate. Journal of Neural Transmission. 2004;111:511-514.
6. 6-Akçıl EF, Dilmen ÖK, Vehid H, Tunalı Y. Can Amantadine Ameliorate Neurocognitive Functions After Subarachnoid Haemorrhage? A Preliminary Study. Turk J Anaesthesiol Reanim. 2018;46:100-107.
7. 7-Bakay RA, Sweeney KM, Wood JH. Patho- physiology of cerebrospinal fluid in head in- jury: Part 1; pathological changes in cereb rospinal fluid solute composition after traumatic injury. Neurosurgery. 1986;18:234–243.
8. 8-Meythaler JM, Peduzzi-Nelson J, Eleftheriou E, Novack TA. Current concepts: diffuse axonal in- jury as- sociated traumatic brain injury. Arch Phys Med Rehabil. 2001;82:1461–1471.

9. 9-Sawyer E, Mauro LS, Ohlinger MJ. Amantadine Enhancement of Arousal and Cognition After Traumatic Brain Injury. The Annals of Pharmacotherapy. 2008;42:247-252.
10. 10-Hamill RW, Woolf PD, McDaonald JV, Lee LA, Kelly M. Catecholamines predict outcome in traumatic brain injury. Ann Neuro. 1987;21:438-443.
11. 11-Giacino JT, Whyte J, Bagiella E, et al.Placebo-Controlled Trial of Amantadine or Se- vere Traumatic Brain Injury. N Engl J Med. 2012;366:819-826.
12. 12-Nickels JL, Schneider WN, Dombovy ML, Wong TM. Clinical use of Amantadine in brain injury rehabilitation. Brain Inj. 1994;8:709-718.
13. 13-Krivonos OV, Amasova NA, Smolentseva IG. Use of the glutamate NMDA receptor anatag- onist PK-Merz in acute stroke. Neurosci and Behav. Physio. 2009;40:72-74.
14. 14-Wu ST, Garmel GM. Improved neurological function after amantadine treatment in two pa- tients with brain injury. J Emerg Med. 2005;28:289-292.
15. 15-Aksu NM, Senlikci H, Akkass M, Ozmen NM. The Neurological Improvement of a Patient after Amantadine Infusion. JAEMCR. 2013;4:161-163.
16. 16-Tutal ZB, Ozayar E, Kenan I, et al. Neurolog- ical Recovery after Amantadine Treatment in a Patient with Septic Arthritis: A Case Report. J Turk Soc Intens Care. 2016;14:39-42.
17. 17-Steube D, Görtelmeyer R. The Influence of Amantadine Sulfate on Disturbances of Arousal after Severe Traumatic Brain Injury. Neurology & Rehabilitation. 2000;6:307-312.
18. 18-Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale–Revised: measure- ment characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004;85:2020-2029.
19. 19-Jeong JH , Park YJ, Kim DH, et al. The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction. BMC Surgery. 2017;17:77.