Jokar et al. (2017)

Iran

RCT

PEDro=7

N=80

Population: TBI; Tranexamic Acid (TA) (n=40): Mean Age=35.4 yr; Gender: Male=32, Female=8. Placebo (n=40): Mean Age=36.2 yr; Gender: Male=28, Female=12.

Intervention: Patients were randomized toreceive either tranexamic acid (a bolus of 1 g over 10min followed by a continuous infusion of 1 g over 8 hr) or placebo in addition to standard ICH care.

Outcome Measures: Extent of Intracranial Hemorrhage (ICH) growth, Initial ICH volume.

1.         Initial ICH volume was similar for both groups (TA=21.6 ml, placebo=22.2 ml; p=0.83). However, 48 h after treatment begain ICH volume was significantly less in the TA group compared to placebo (TA=23.3 ml, placebo=26.5 ml; p=0.04).

2.         ICH growth was significantly larger in the placebo group compared to the TA group (p<0.001).

Moghaddam et al.(2017)

Iran

RCT

PEDro=8

N=113

Population: TBI; Selenium Group (n=57): Mean Age=40.07 yr; Gender: Male=45, Female=12. Control Group (n=56): Mean Age=42.93 yr; Gender: Male=45, Female=11.

Intervention: Patients were randomized to received either selenium (within 8h after injury) plus standard treatment, or standard treatment alone (control).

Outcome Measures: Glasgow Outcome Scale Extended (GOS-E), Full Outline of Unresponsiveness sore (FOUR), Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation III (APACHE), Side Effects, Length of Stay (LOS).

1.         There were no significant between group differences for any of the outcome measures.

2.         For side effects in the selenium group, 1 patient reported nausea and 3 patients had facial flushing.

Humble et al. (2016)

USA

Case Series

N=85

Population: Severe TBI; Median Age=35; Gender: Male=73, Female=12; Median GCS=3.

Intervention: Medical records for patients who received dexmedetomidine infusions were identified.

Outcome Measures: Blood Pressure (BP), Heart Rate (HR), Glasgow Coma Scale (GCS), Richmond Agitation-Sedation Scale (RASS), Opioid Dosage.

1.         BP and HR decreased during dexmedetomidine infusion and returned to baseline levels after infusion.

2.         GCS increased from 8 to 9.5 pre-infusion to infusion (p<0.01), and from 9.5 to 10 infusion to post-infusion (p<0.01).

3.         RASS scores increased significantly from pre-infusion to infusion and from infusion to post-infusion (p<0.01 and p<0.05, respectively).

4.         Fifty-one patients received propofol and 35 received midazolam during the study period.

Ko et al. (2016)

USA

Case Control

N=440

Population: TBI; Early propanolol (n=109): Mean Age=57.7 yr; Gender: Male=293, Female=137; Mean GCS=12.2. Control (n=331): Mean Age=60.4 yr; Gender: Male=216, Female=115; Mean GCS=12.4.

Intervention: Patients were administered low-dose intravenous propranolol (1 mg every 6 hr) in the early stages post-TBI and compared with controls.

Outcome Measures: Days on a Ventilator, Mortality, Length of Stay (LOS).

1.         The early propranolol group had significantly more days on a ventilator than the control group (p<0.001).

2.         When controlling for associated risk factors, early propranolol was independently associated with lower mortality (p=0.012).

3.         No significant differences were found between groups for LOS.

Neilson et al. (2016)

Singapore

Case Control

N=118

Population: Severe TBI; Mean Age=70.2; Median GCS=5.

Intervention: Patient records were identified from a database of patients with severe TBI who were admitted with head injury from 2006-2009. Each patient that was taking statin prior to injury was matched to a patient with no prior statin use.

Outcome Measures: Mortality, Glasgow Outcome Scale (GOS).

1.         Based on the Kaplan-Meier curve, the median survival at 14 days between statin users and non-statin users was not significantly different (p=0.13). The same result was found for survival at 6mo (p=0.14).

2.         At 6 mo, there was no significant between group difference in median GOS (p=0.11).

Picetti et al. (2016)

Italy

Pre-Post Test

N=30

Population: ABI; Mean Age=50.1 yr; Gender: Male=17, Female=13; Median GCS=6.

Intervention: Patients received Diclofenac Sodium (DCFS, 12.5 mg) intramuscularly for fever control. The study duration was 2 hr.

Outcome Measures: Core Body Temperature (T_c), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), Heart Rate (HR), Cerebral Perfusion Pressure (CPP).