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Amantadine as an Aid to Extubation in Severe Acute Brain Injury: A Case Series.
Fang, Benjamin; Angulo Castro, Sergio; McHugh, Daryl C.
Afiliación
  • Fang B; School of Medicine & Dentistry, University of Rochester Medical Center, Rochester, NY, United States.
  • Angulo Castro S; Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States.
  • McHugh DC; Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States.
Neurohospitalist ; 14(3): 284-287, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38895006
ABSTRACT
For a subset of patients with severe acute brain injury (SABI) undergoing invasive mechanical ventilation, the primary barrier to successful extubation is depressed mental status. Amantadine is a neurostimulant that has been demonstrated to increase arousal and improve functional outcomes in patients with SABI. In this case series, we describe 5 patients with SABI and invasive mechanical ventilation who received amantadine as an agent to improve mental status to allow extubation. The primary barrier to extubation for all patients was depressed mental status. Median age was 77 (range 32 to 82). Primary diagnoses were ischemic stroke (n = 1), subdural hemorrhage (n = 2), intracerebral hemorrhage (n = 1), and traumatic brain injury (n = 1). Median Glasgow Coma Score was 7T prior to administration of amantadine and 10T on the day after amantadine was initiated, with improvements in eye-opening and motor response. Four patients displayed improvement in arousal and attention and were successfully extubated 1 to 4 days after initiation of amantadine (median 2 days). The fifth patient only displayed marginal improvement in mental status after starting amantadine, but was ultimately able to be extubated 7 days later. Amantadine may improve the likelihood of or reduce the time to successful extubation in patients with SABI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Neurohospitalist Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Neurohospitalist Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos