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April 7, 2021Journal of Neurotrauma28 citations

Pharmacological Management of Paroxysmal Sympathetic Hyperactivity: A Scoping Review

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Why the study?

What pharmacological treatments are used for the management of paroxysmal sympathetic hyperactivity following acute severe brain injury?

Population

459 adult and pediatric patients with an acute neurological insult complicated by paroxysmal sympathetic…

Design

Systematic_review

Key result

Pharmacological management of paroxysmal sympathetic hyperactivity involved 48 drugs from 22 classes across 459 patients, but inconsistent reporting precluded any summary of outcomes.

Authors

JTJustin TuJRJake ReeveADAdam M. Deane

Discussion

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Overview

No consistent outcome data guide drug selection; leaves open standardized prospective trials for paroxysmal sympathetic hyperactivity.

Study Design

Type

Systematic Review (n=459)

Structured PICO

What pharmacological treatments are used for the management of paroxysmal sympathetic hyperactivity following acute severe brain injury?

P
Population
459 adult and pediatric patients with paroxysmal sympathetic hyperactivity following acute severe brain injury across 56 studies.
I
Intervention
Pharmacological treatment of PSH (48 drugs from 22 classes, most frequently benzodiazepines, β-blockers, opioids, α-2 agonists, and baclofen).
O
Outcome
Pharmacological management strategies and subsequent outcomes (inconsistently reported).

A wide variety of drugs are used to treat paroxysmal sympathetic hyperactivity after severe brain injury, but there is a lack of moderate-quality evidence to guide clinical decision-making.

Limitations

  • Route and dose of drug and subsequent outcome were inconsistently reported, such that no summary was possible
  • Lack of even moderate-quality evidence to inform clinical decision making
  • Inconsistent reporting of route and dose of drug and subsequent outcome

Cite This Study

Tu et al. (2021) conducted a systematic review in Paroxysmal sympathetic hyperactivity (n=459). Pharmacological management was evaluated on Pharmacological treatment outcomes. Pharmacological management of paroxysmal sympathetic hyperactivity involved 48 drugs from 22 classes across 459 patients, but inconsistent reporting precluded any summary of outcomes.

synapsesocial.com/papers/6a98262490d51c6c12faf909https://doi.org/10.1089/neu.2020.7597
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Treatment of paroxysmal sympathetic storm with labetalol2000 · 67 citations
  2. 2Successful Intrathecal Baclofen Therapy for Intractable Paroxysmal Sympathetic Hyperactivity in Patient with Pontine Hemorrhage: A case report2018 · 7 citations
  3. 3Paroxysmal sympathetic hyperactivity in the neurological intensive care unit2007 · 162 citations
  4. 4A review of paroxysmal sympathetic hyperactivity after acquired brain injury2010 · 319 citations