الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
One of the leading causes of mortality and neurological impairment after blunt trauma is traumatic brain injury. There are currently few treatment options available for this patient group that are supported by evidence. The neuroendocrine system’s interaction with the damaged brain is well-documented. Following a traumatic brain injury, there is an increase in catecholamines in the blood and urine. These levels are associated with many outcomes, including the Glasgow Coma Scale (GCS) at admission, the Glasgow Outcome Score (GOS) at one month, neurologic recovery, duration of stay, and reliance on a ventilator.
The purpose of this study was to compare the effects of placebo and metoprolol treatment on mortality, length of hospital stay, intensive care unit stay, duration of mechanical ventilation, and Glasgow Outcome Score at one month in patients with severe traumatic brain injuries who were admitted within 24 hours of injury. Additionally, this research aimed to determine which age group of patients on metoprolol would have a mortality advantage, as well as the relationship between early heart rate DROP to the target range (80-90 b/min) and the aforementioned characteristics in the metoprolol group alone.
In this research, 80 patients hospitalized to the Critical Care Department of Alexandria Main University Hospital with acute isolated blunt severe traumatic brain injuries met the inclusion and exclusion criteria. Two groups of patients were randomly assigned to receive basic therapy. Both groups were instructed to maintain a patent airway, sufficient breathing, and euvolemia using IV fluids. They were also instructed to keep their core temperature normal, use anti-seizure medication, and take steps to lower their intracranial pressure. The first group served as a placebo control, while the second group was given metoprolol intravenously starting at 5 mg and increasing by 5 mg every five minutes until the goal heart rate (80-90 b/min) was attained or the maximum dosage of 15 mg was reached. At the 30-day post-traumatic growth-stage assessment, both groups were monitored until death or release.
Measurements:
1. Longitudinal variables such as MV, ICU and hospital stays, GOS, and in-hospital mortality were compared between the two groups.
2. In terms of intensive care unit and hospital stay, GOS, and in-hospital mortality, early and late achievers of the goal HR were compared.
3. We compared the two groups’ mortality rates by age, with 40 years serving as our threshold.
4. Disparity in mortality rates between the two categories as a function of brain damage kind.
5. In order to find independent predictors of death in all 80 patients, a logistic regression model was run.
Results:
• While there was no change in hospital stay, there was a statistically significant decrease in mortality, intensive care unit stay, mechanical ventilation days, and a statistically significant improvement in Glasgow outcome score with metoprolol usage.