Beta-blockers for traumatic brain injury: a systematic review and meta-analysis.

摘要: BACKGROUND Paroxysmal sympathetic hyperactivity (PSH) and catecholamine surge, which are associated with poor outcome, may be triggered by traumatic brain injury (TBI).β Adrenergic receptor blockers (β-blockers), as potential therapeutic agents to prevent paroxysmal have been shown improve survival after TBI. The principal aim of this study was investigate the effect β-blockers on outcomes in patients METHODS For systematic review meta-analysis, we searched MEDLINE, EMBASE, Cochrane Library databases from inception September 25, 2020, for randomized controlled trials, nonrandomized observational studies reporting following TBI: mortality, functional measures, cardiopulmonary adverse effects (e.g., hypotension, bradycardia, bronchospasm). With use random-effects model, calculated pooled estimates, confidence intervals (CIs), odds ratios (ORs) all outcomes. RESULTS Fifteen 12,721 were included. Exposure TBI a significant reduction adjusted in-hospital mortality (OR, 0.39; 95% CI, 0.30-0.51; I2 = 66.3%; p < 0.001). β-Blockers significantly improved long-term (≥6 months) outcome 1.75; 1.09-2.80; 0%; 0.02). Statistically difference not seen events 0.91; 0.55-1.50; 25.9%; 0.702). CONCLUSION This meta-analysis demonstrated that administration safe effective. Administration therefore suggested care. However, more high-quality trials needed management LEVEL OF EVIDENCE Systematic level III.