| Acute management of acquired brain injury Part III: an evidence-based review of interventions used to promote arousal from coma. | |
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MedLine Citation:
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PMID: 20334468 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PRIMARY OBJECTIVE: To review the literature regarding techniques used to promote arousal from coma following an acquired brain injury. MAIN OUTCOMES: A literature search of multiple databases (CINAHL, EMBASE, MEDLINE and PsycINFO) and hand searched articles covering the years 1980-2008 was performed. Peer reviewed articles were assessed for methodological quality using the PEDro scoring system for randomized controlled trials and the Downs and Black tool for RCTs and non-randomized trials. Levels of evidence were assigned and recommendations were made. RESULTS: Research into coma arousal has generally focused on the stimulation of neural pathways responsible for arousal. These pathways have been targeted using pharmacological and non-pharmacological techniques. This review reports the evidence surrounding agents targeting dopamine pathways (amantadine, bromocriptine and levodopa), sensory stimulation, music therapy and median nerve electrical stimulation. Each of these interventions has shown some degree of benefit in improving consciousness, but further research is necessary. CONCLUSIONS: Despite numerous studies, strong evidence was only found for one intervention (Amantadine use in children) and this was based on a single study. However, each of the interventions showed promise in some aspect of arousal and warrant further study. More methodologically rigorous study is needed before any definitive conclusions can be drawn. |
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Authors:
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Matthew J Meyer; Joseph Megyesi; Jay Meythaler; Manuel Murie-Fernandez; Jo-Anne Aubut; Norine Foley; Katherine Salter; Mark Bayley; Shawn Marshall; Robert Teasell |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Brain injury : [BI] Volume: 24 ISSN: 1362-301X ISO Abbreviation: Brain Inj Publication Date: 2010 |
Date Detail:
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Created Date: 2010-04-07 Completed Date: 2010-08-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710358 Medline TA: Brain Inj Country: England |
Other Details:
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Languages: eng Pagination: 722-9 Citation Subset: IM |
Affiliation:
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Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, London, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Amantadine
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therapeutic use Arousal / drug effects, physiology* Brain Injuries / physiopathology, therapy* Bromocriptine / therapeutic use Coma, Post-Head Injury / physiopathology, therapy* Dopamine Agonists / therapeutic use Evidence-Based Medicine Humans Levodopa / therapeutic use Music Therapy Randomized Controlled Trials as Topic Recovery of Function* / drug effects, physiology |
| Chemical | |
Reg. No./Substance:
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0/Dopamine Agonists; 0/Levodopa; 25614-03-3/Bromocriptine; 768-94-5/Amantadine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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