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Annals of Surgery Dec 2017To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI).
BACKGROUND
There have been no new inpatient pharmacologic therapies to improve TBI outcomes in a half-century. Treatment of TBI patients with β-blockers offers a potentially beneficial approach.
METHODS
Using MEDLINE, EMBASE, and CENTRAL databases, eligible articles for our systematic review and meta-analysis (PROSPERO CRD42016048547) included adult (age ≥ 16 years) blunt trauma patients admitted with TBI. The exposure of interest was β-blocker administration initiated during the hospitalization. Outcomes were mortality, functional measures, quality of life, cardiopulmonary morbidity (e.g., hypotension, bradycardia, bronchospasm, and/or congestive heart failure). Data were analyzed using a random-effects model, and represented by pooled odds ratio (OR) with 95% confidence intervals (CI) and statistical heterogeneity (I).
RESULTS
Data were extracted from 9 included studies encompassing 2005 unique TBI patients with β-blocker treatment and 6240 unique controls. Exposure to β-blockers after TBI was associated with a reduction of in-hospital mortality (pooled OR 0.39, 95% CI: 0.27-0.56; I = 65%, P < 0.00001). None of the included studies examined functional outcome or quality of life measures, and cardiopulmonary adverse events were rarely reported. No clear evidence of reporting bias was identified.
CONCLUSIONS
In adults with acute TBI, observational studies reveal a significant mortality advantage with β-blockers; however, quality of evidence is very low. We conditionally recommend the use of in-hospital β-blockers. However, we recommend further high-quality trials to answer questions about the mechanisms of action, effectiveness on subgroups, dose-response, length of therapy, functional outcome, and quality of life after β-blocker use for TBI.
Topics: Adrenergic beta-Antagonists; Brain Injuries; Bronchial Spasm; Cardiovascular Diseases; Hospital Mortality; Humans; Quality of Life; Treatment Outcome
PubMed: 28525411
DOI: 10.1097/SLA.0000000000002286 -
Anesthesia Progress 1991
Review
Topics: Airway Obstruction; Ambulatory Surgical Procedures; Anaphylaxis; Anesthesia, Dental; Anesthesia, General; Anesthetics; Barbiturates; Bronchial Spasm; Drug Interactions; Emergencies; Etomidate; Humans; Ketamine; Malignant Hyperthermia; Muscle Relaxants, Central; Narcotics; Propofol; Pulmonary Edema
PubMed: 1819969
DOI: No ID Found -
Anesthesiology Nov 1973
Topics: Adult; Anaphylaxis; Bronchial Spasm; Drug Hypersensitivity; Edema; Face; Humans; Male; Skin Tests; Succinylcholine; Thiamylal; Tubocurarine; Urticaria
PubMed: 4746063
DOI: 10.1097/00000542-197311000-00024 -
Archives of Emergency Medicine Jun 1989
Topics: Alcoholic Intoxication; Asthma; Bronchial Spasm; Humans
PubMed: 2742674
DOI: 10.1136/emj.6.2.159-a -
Einstein (Sao Paulo, Brazil) 2021To examine the impact of climate variability on the occurrence of exercise-induced bronchospasm in the rainy and dry seasons of a Brazilian semi-arid region.
OBJECTIVE
To examine the impact of climate variability on the occurrence of exercise-induced bronchospasm in the rainy and dry seasons of a Brazilian semi-arid region.
METHODS
This sample comprised 82 adolescents aged 15 to 18 years, who were submitted to exercise-induced bronchospasm assessment on a treadmill and outdoors, during the rainy and the dry season. Anthropometric variables, sexual maturity and forced expiratory volume in the first second were analyzed. Air temperature and humidity, decline in forced expiratory volume in the first second (%) and frequency of bronchospasm were compared between seasons using the independent Student's t test, the Wilcoxon and McNemar tests, respectively. The level of significance was set at p<0.05.
RESULTS
The mean age was 15.65±0.82 years. Air temperature, air humidity and decline in forced expiratory volume in the first second (%) differed between seasons, with higher air temperature and humidity in the rainy season (29.6ºC±0.1 and 70.8%±0.6 versus 28.5ºC±0.2 and 48.5%±0.6; p<0.05). The decline in forced expiratory volume in the first second (%) was greater in the dry season (9.43%±9.97 versus 12.94%±15.65; p<0.05). The frequency of bronchospasm did not differ between seasons.
CONCLUSION
The dry season had a negative impact on forced expiratory volume in the first second in adolescents, with greater decrease detected during this period. Findings of this study suggested bronchospasm tends to be more severe under low humidity conditions.
Topics: Adolescent; Asthma, Exercise-Induced; Bronchial Spasm; Exercise Test; Forced Expiratory Volume; Humans; Seasons
PubMed: 34586155
DOI: 10.31744/einstein_journal/2021AO5744 -
Archives of Disease in Childhood Feb 1969
Review
Topics: Adult; Allergens; Asthma; Bronchi; Bronchial Spasm; Child; Dust; Fungi; Histamine; Humans; Hypersensitivity; Infections; Skin Tests
PubMed: 4885538
DOI: 10.1136/adc.44.233.1 -
Allergology International : Official... Jul 2020
Topics: Adult; Aged; Allergens; Anesthesia, General; Anesthetics; Bronchial Spasm; Female; Humans; Male; Middle Aged; Overweight; Retrospective Studies; Risk Factors; Skin Tests
PubMed: 31959499
DOI: 10.1016/j.alit.2019.12.012 -
Respiratory Care Nov 2012
Topics: Anesthetics, Inhalation; Biopsy; Bronchial Spasm; Exercise Test; Humans; Humidity; Nebulizers and Vaporizers; Pulmonary Gas Exchange; Respiration, Artificial; Respiratory Distress Syndrome; Respiratory Therapy; Risk Factors; Sleep Wake Disorders; Tracheostomy
PubMed: 23213644
DOI: No ID Found -
Archives of Emergency Medicine Sep 1988A case of alcoholic beverage sensitivity is described which presented as acute bronchospasm. Such reactions in asthmatics are not uncommon, though their severity may be...
A case of alcoholic beverage sensitivity is described which presented as acute bronchospasm. Such reactions in asthmatics are not uncommon, though their severity may be underestimated in the presence of intoxication. Indeed, such patients may be dismissed as suffering only from the effects of intoxication with obvious consequences.
Topics: Alcoholic Intoxication; Asthma; Bronchial Spasm; Ethanol; Female; Humans; Hypersensitivity, Immediate; Middle Aged; Respiratory Hypersensitivity
PubMed: 3178980
DOI: 10.1136/emj.5.3.186 -
British Journal of Clinical Pharmacology 1982This paper reviews the nature and clinical value of intrinsic sympathomimetic activity (ISA) as a property of β-adrenoceptor blocking drugs. It suggests that ISA may... (Review)
Review
This paper reviews the nature and clinical value of intrinsic sympathomimetic activity (ISA) as a property of β-adrenoceptor blocking drugs. It suggests that ISA may reduce the incidence of certain cardiac, respiratory and peripheral vascular side effects including bronchospasm, peripheral vasospasm and rebound tachycardia and cardiac arrhythmias.
Topics: Adrenergic beta-Antagonists; Bronchial Spasm; Heart Diseases; Humans; Myocardial Contraction; Raynaud Disease; Sympathomimetics
PubMed: 6125183
DOI: 10.1111/j.1365-2125.1982.tb01935.x