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October 18, 2019Journal of Pediatric Intensive CareOpen Access

Management of Paroxysmal Sympathetic Hyperactivity with Dexmedetomidine and Propranolol Following Traumatic Brain Injury in a Pediatric Patient

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Why the study?

Does the combination of dexmedetomidine and propranolol improve symptoms of paroxysmal sympathetic hyperactivity in a pediatric patient following traumatic brain injury?

Population

An 8-year-old male with PSH following blunt traumatic subdural hematoma and diffuse axonal injury

Comparison

Dexmedetomidine and propranolol

Design

Case report

Key result

The combination of dexmedetomidine and propranolol successfully attenuated signs and symptoms of refractory paroxysmal sympathetic hyperactivity in a pediatric patient following severe traumatic brain injury.

Authors

JBJoshua W. BranstetterKOKelsey OhmanDJDonald W. Johnson

Discussion

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Member takes

Overview

May support dexmedetomidine-propranolol for refractory pediatric PSH; hypothesis-generating and needs prospective trials before adoption.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does the combination of dexmedetomidine and propranolol improve symptoms of paroxysmal sympathetic hyperactivity in a pediatric patient following traumatic brain injury?

P
Population
An 8-year-old male with refractory paroxysmal sympathetic hyperactivity following severe traumatic brain injury treated with dexmedetomidine and propranolol.
I
Intervention
Dexmedetomidine and propranolol
O
Outcome
Symptomatic resolution of paroxysmal sympathetic hyperactivity (reduction in frequency and severity of acute episodes)

Dexmedetomidine and propranolol may be effective in attenuating signs and symptoms of paroxysmal sympathetic hyperactivity in pediatric patients following traumatic brain injury.

Limitations

  • Single case report
  • Lack of a comparator group
  • Lack of validated diagnostic criteria for PSH in pediatric patients
  • Confounding effects of multiple treatment modalities

Cite This Study

Branstetter et al. (2019) conducted a case report in Paroxysmal sympathetic hyperactivity following traumatic brain injury (n=1). Dexmedetomidine and Propranolol was evaluated on Symptomatic resolution of PSH. The combination of dexmedetomidine and propranolol successfully attenuated signs and symptoms of refractory paroxysmal sympathetic hyperactivity in a pediatric patient following severe traumatic brain injury.

synapsesocial.com/papers/6a9f926da9209741c615dc37https://doi.org/10.1055/s-0039-1698758
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