The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study
Introduction: Traumatic brain injury (TBI) is one of the most common causes of death and an important burden to the worldwide healthcare system and society. There is a lack of guidelines for types of monitoring or neuroprotective therapy. The aim of this pilot study was to assess its feasibility and...
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| Format: | Article |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/2/353 |
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| author | Konrad Jarosz Klaudyna Kojder Karolina Skonieczna-Żydecka Agata Andrzejewska Joanna Sołek-Pastuszka Anna Jurczak |
| author_facet | Konrad Jarosz Klaudyna Kojder Karolina Skonieczna-Żydecka Agata Andrzejewska Joanna Sołek-Pastuszka Anna Jurczak |
| author_sort | Konrad Jarosz |
| collection | DOAJ |
| description | Introduction: Traumatic brain injury (TBI) is one of the most common causes of death and an important burden to the worldwide healthcare system and society. There is a lack of guidelines for types of monitoring or neuroprotective therapy. The aim of this pilot study was to assess its feasibility and, furthermore, to evaluate the impact of Cerebrolysin on the following clinical outcomes: length of stay, Glasgow Outcome Scale (GOS) and mortality. Methods: A cohort of 56 patients was included in this non-randomised, real-time, pre–post-interventional study. The patients were assessed with the Glasgow Coma Scale (GCS) and divided into two groups: severe (GCS < 8) and non-severe (GCS > 8). After the radiological examination (CT scan), the patients were qualified for an immediate neurosurgical procedure if needed. The patients were admitted to the intensive care unit, where a standardised protocol for TBI treatment was implemented. Additional neuromonitoring was applied. Results: There were 56 patients (19 females; 33.9%), of which 41 were considered severe cases; the patients were allocated to the Cerebrolysin (<i>n</i> = 25) or control groups (<i>n</i> = 31). In a generalised linear model (GLM) approach, the use of Cerebrolysin was associated with a decrease in the probability of death in non-severe patients (by 0.333 (standard error (SE) = 0.157, <i>p</i> = 0.034)) but not in severe patients (estimate (Est.) = −0.115, SE = 0.127, <i>p</i> = 0.364). Patients who received Cerebrolysin and who were neuromonitored had favourable outcomes and better survival rates. Conclusions: A multimodal treatment approach with monitoring and Cerebrolysin may have a beneficial effect on patients with less severe TBIs; however, the present study has multiple limitations, and further research is needed. |
| first_indexed | 2024-03-08T09:52:16Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T09:52:16Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-c507842c5fd24042937793a1cbfe1f672024-01-29T14:01:03ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113235310.3390/jcm13020353The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot StudyKonrad Jarosz0Klaudyna Kojder1Karolina Skonieczna-Żydecka2Agata Andrzejewska3Joanna Sołek-Pastuszka4Anna Jurczak5Anesthesiology and Intensive Care, University Hospital no. 1 Unii Lubelskiej, 71-252 Szczecin, PolandAnesthesiology and Intensive Care, University Hospital no. 1 Unii Lubelskiej, 71-252 Szczecin, PolandDepartment of Biochemical Sciences, Pomeranian Medical University, 71-460 Szczecin, PolandAnesthesiology and Intensive Care, University Hospital no. 1 Unii Lubelskiej, 71-252 Szczecin, PolandAnesthesiology and Intensive Care, University Hospital no. 1 Unii Lubelskiej, 71-252 Szczecin, PolandDepartment of Specialist Nursery, Pomeranian Medical University, Zolnierska 48, 71-210 Szczecin, PolandIntroduction: Traumatic brain injury (TBI) is one of the most common causes of death and an important burden to the worldwide healthcare system and society. There is a lack of guidelines for types of monitoring or neuroprotective therapy. The aim of this pilot study was to assess its feasibility and, furthermore, to evaluate the impact of Cerebrolysin on the following clinical outcomes: length of stay, Glasgow Outcome Scale (GOS) and mortality. Methods: A cohort of 56 patients was included in this non-randomised, real-time, pre–post-interventional study. The patients were assessed with the Glasgow Coma Scale (GCS) and divided into two groups: severe (GCS < 8) and non-severe (GCS > 8). After the radiological examination (CT scan), the patients were qualified for an immediate neurosurgical procedure if needed. The patients were admitted to the intensive care unit, where a standardised protocol for TBI treatment was implemented. Additional neuromonitoring was applied. Results: There were 56 patients (19 females; 33.9%), of which 41 were considered severe cases; the patients were allocated to the Cerebrolysin (<i>n</i> = 25) or control groups (<i>n</i> = 31). In a generalised linear model (GLM) approach, the use of Cerebrolysin was associated with a decrease in the probability of death in non-severe patients (by 0.333 (standard error (SE) = 0.157, <i>p</i> = 0.034)) but not in severe patients (estimate (Est.) = −0.115, SE = 0.127, <i>p</i> = 0.364). Patients who received Cerebrolysin and who were neuromonitored had favourable outcomes and better survival rates. Conclusions: A multimodal treatment approach with monitoring and Cerebrolysin may have a beneficial effect on patients with less severe TBIs; however, the present study has multiple limitations, and further research is needed.https://www.mdpi.com/2077-0383/13/2/353traumatic brain injury (TBI)CerebrolysinAmantadineneuromonitoringnear-infrared spectroscopy (NIRS)optic nerve sheath diameter (ONSD) |
| spellingShingle | Konrad Jarosz Klaudyna Kojder Karolina Skonieczna-Żydecka Agata Andrzejewska Joanna Sołek-Pastuszka Anna Jurczak The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study Journal of Clinical Medicine traumatic brain injury (TBI) Cerebrolysin Amantadine neuromonitoring near-infrared spectroscopy (NIRS) optic nerve sheath diameter (ONSD) |
| title | The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study |
| title_full | The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study |
| title_fullStr | The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study |
| title_full_unstemmed | The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study |
| title_short | The Effects of Neuromonitoring and Cerebrolysin Administration on Outcomes in Patients with Traumatic Brain Injury—An Interventional Pilot Study |
| title_sort | effects of neuromonitoring and cerebrolysin administration on outcomes in patients with traumatic brain injury an interventional pilot study |
| topic | traumatic brain injury (TBI) Cerebrolysin Amantadine neuromonitoring near-infrared spectroscopy (NIRS) optic nerve sheath diameter (ONSD) |
| url | https://www.mdpi.com/2077-0383/13/2/353 |
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