Role of Propranolol and Clonidine in Sympathetic Hyperactivity After Severe Traumatic Brain Injury
Clinical Neurology and Neuroscience
Volume 1, Issue 4, November 2017, Pages: 96-103
Received: Jun. 5, 2017; Accepted: Jun. 22, 2017; Published: Oct. 24, 2017
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Mohamed Mostafa Megahed, Critical Care Medicine, Critical Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Tamer Nabil Habib, Critical Care Medicine, Critical Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Zeyad Moqbel, Radiodiagnosis Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Riyad Abdullah Almogahed, Critical Care Medicine, Critical Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Islam El Sayed Mohamed Ahmed, Clinical Pharmacy Specialist, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
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Sympathetic hyperactivity following severe traumatic brain injury (TBI) has compounding negative consequences on many body organs. Adrenergic blockade using beta blockers and alpha 2 agonists demonstrated positive effects in decreasing sympathetic hyperactivity and increasing survival. This study was conducted on 50 adult patients with severe TBI randomly assigned into two groups. Intervention group received propranolol 40 mg BID and clonidine 150 µg BID for 7 days. Control group didn’t receive any beta blockers or alpha 2 agonists. The primary outcome was plasma norepinephrine level on day 8. Intervention group showed 20% reduction in plasma norepinephrine, while control group showed 10% reduction only. Glasgow coma score (GCS) and full outline of unresponsiveness (FOUR) score didn’t show any significant differences (p = 0.554). Heart rate was significantly decreased in intervention group (p = 0.002), mean arterial pressure also decreased (p = 0.007), as well as respiratory rate (p = 0.001). Ventilator free days, coma free days, ICU length of stay, and mortality didn’t differ significantly between the two groups. Propranolol and clonidine at the specified doses may decrease the sympathetic hyperactivity in patients suffering from severe traumatic brain injury.
Critical, Neurology, Trauma, β-Blocker, α-Agonist
To cite this article
Mohamed Mostafa Megahed, Tamer Nabil Habib, Zeyad Moqbel, Riyad Abdullah Almogahed, Islam El Sayed Mohamed Ahmed, Role of Propranolol and Clonidine in Sympathetic Hyperactivity After Severe Traumatic Brain Injury, Clinical Neurology and Neuroscience. Vol. 1, No. 4, 2017, pp. 96-103. doi: 10.11648/j.cnn.20170104.14
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