The features of Amantadine use for severe traumatic brain injury at the Neurosurgery Intensive Care Unit of Lithuanian University of Health Sciences hospital Kaunas Clinics

Justė Bučiūnaitė1, Karolina Dambrauskaitė1, Neringa Balčiūnienė3, Tomas Tamošuitis3, Asta Krikščionaitienė2

1Lithuanian University of Health Sciences, Medical academy, Faculty of Medicine, A. Mickevičiaus str. 9, LT 44307 Kaunas, Lithuania.

2Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Emergency Medicine, Eivenių str. 4, LT 50161 Kaunas, Lithuania.

3Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Intensive Care, Eivenių str. 2, LT 50009 Kaunas, Lithuania.

  

Abstract

 

Background: Amantadine is a non-competitive antagonist of dopamine and NMDA receptors. Studies have shown amantadine’s positive effect on the outcome of patients with reduced consciousness induced by traumatic brain injury. The aim of the study was to analyze the usage of amantadine in treating patients with traumatic brain injury in the Neurosurgery Intensive Care Unit (ICU).

Materials and methods:

The retrospective analysis of the case histories of the patients with traumatic brain injury has been carried out at the Neurosurgery ICU of Lithuanian University of Health Sciences hospital Kaunas Clinics from 1st of January 2017 to 30th of June 2018. Patients were grouped according to the use of amantadine and compared by age, Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS) score averages. The estimation of averages of trauma mechanism, localization, morphology, amantadine administration, duration of mechanical ventilation, types of surgeries, pupil reactions was made. Significance level: p<0.05.

Results: The data from 79 case histories was analyzed. 29 patients administered amantadine. The mean age of group taking amantadine was 55.4 (16.4) years and 70.2 (15.1) of the other group. Amantadine group presented with lower GCS score on the site of accident, but had higher GOS score. Regression analysis indicates that GOS score is related to younger age (0.015).

Conclusion: Patients treated with amantadine were younger and had lower level of consciousness on the site of accident, though they showed greater level of recovery after the hospitalization. The key factor inducing better recovery was not the amantadine therapy, but younger age.

 

Keywords: traumatic brain injury, amantadine, level of consciousness.