成年创伤性脑损伤患者群体中的抗发作药物治疗实践
Aubree J Houston1, Charles S Wilson2, Brian W Gilbert3
1PGY-2 Pediatric Pharmacy Resident, Department of Pharmacy, Nicklaus Children's Hospital, 3100 SW 6nd Avenue, Miami, FL 33155, United States of America.
The American journal of emergency medicine
|October 19, 2024
概括
大多数美国创伤中心在创伤性脑损伤 (TBI) 后使用 levetiracetam (LEV) 进行预防,偏离了指导方针. 这种做法是常见的,无论中心的类型或位置.
科学领域:
- 神经学 神经学
- 创伤外科 手术 创伤外科
- 临床药房 临床药房
背景情况:
- 抗发作药物 (ASM) 对于预防创伤性脑损伤 (TBI) 患者早期发作至关重要.
- 目前在TBI中对ASM选择和剂量的做法在美国创伤中心之间有很大的差异.
研究的目的:
- 识别和描述美国成人创伤中心使用的常见创伤后发作 (PTS) 预防方案.
- 了解ASM在脑损伤患者使用中的当前趋势.
主要方法:
- 为了评估PTS预防实践,在2023年3月开发和分发了一项调查.
- 数据分析包括基于中心人口统计,学术地位,创伤指标和年度TBI数量的子组评估.
主要成果:
- 在84个响应创伤中心中,有97.6%的受访者报告说Levétiracetam (LEV) 是他们选择的ASM.
- 最常见的LEV治疗方案是初始1000毫克剂量,其次是每天两次500毫克.
- 在评估的子组中没有发现显著的实践差异.
结论:
- 在使用LEV用于PTS预防方面存在广泛的共识,尽管它与当前的指导方针不一致.
- 在TBI患者的ASM选择和剂量方面仍然存在显著的实践差异.
- 需要进一步的研究来确定最佳的患者选择,药物和剂量用于PTS预防.
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