高级检索
当前位置: 首页 > 详情页

Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial

文献详情

资源类型:
WOS体系:
Pubmed体系:

收录情况: ◇ SCIE

单位: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital MedicalUniversity, Beijing 100070, People’s Republic of China [2]Departmentof Neurosurgery, Shanghai General Hospital, School of Medicine, ShanghaiJiao Tong University, Shanghai, China [3]Brain Injury Centre, Renji Hospital,School of Medicine, Shanghai Jiao Tong University, Shanghai, China [4]ClinicalResearch Institute, Shanghai Jiao Tong University School of Medicine, Shanghai,China [5]Department of Neurosurgery, Tongji Hospital, Tongji MedicalCollege of HUST, Wuhan, China [6]Department of Neurosurgery, The SecondPeople’s Hospital of Nanning, Nanning, China [7]Department of Neurosurgery,Guangdong Provincial Hospital of Integrated Traditional Chinese and WesternMedicine, Foshan, China [8]Department of Neurosurgery, The People’s Hospitalof PingYang, Pingyang, China [9]Department of Neurosurgery, TangshanGongren Hospital, Tangshan, China [10]Department of Neurosurgery, Linyi People’sHospital, Linyi, China [11]Department of Neurosurgery, Changzhi SecondPeople’s Hospital, Changzhi, China [12]Department of Neurosurgery, SouthTaihu Hospital, Huzhou, China [13]Department of Neurosurgery, The ThirdAffiliated Hospital of PLA Navy Military Medical University, Shanghai, China [14]Department of Neurosurgery, The 421st Hospital of Chinese People’s LiberationArmy, Guangzhou, China [15]Department of Neurosurgery, GuangzhouGeneral Hospital of Guangzhou Military Region, Guangzhou, China [16]Departmentof Neurosurgery, Lishui City People’s Hospital, Lishui, China [17]Departmentof Neurosurgery, Shaoxing People’s Hospital, Shaoxing, China [18]Departmentof Neurosurgery, Tengzhou City Center People’s Hospital, Tengzhou,China [19]Department of Neurosurgery, Harrison International Peace Hospital,Hengshui, China [20]Department of Neurosurgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China [21]Departmentof Neurosurgery, The Brain Hospital of Hunan Province, Changsha,China [22]Department of Neurosurgery, Liaocheng Brain Hospital, Liaocheng,China [23]Department of Neurosurgery, Baoji 3rd Hospital of Chinese People’sLiberation Army, Baoji, China [24]Department of Neurosurgery, Yanjiao People’sHospital, Sanhe, China [25]Department of Neurosurgery, The Fourth AffiliatedHospital of China Medical University, Shenyang, China [26]Departmentof Neurosurgery, Antwerp University Hospital, Edegem, Belgium [27]Universityof Antwerp, Edegem, Belgium [28]Division of Anesthesia, Department of Medicine,University of Cambridge, Cambridge, UK [29]Shanghai Institute of HeadTrauma, Shanghai, China
出处:
ISSN:

关键词: Coma Right median nerve Electrical stimulation Traumatic brain injury

摘要:
Severe traumatic brain injury (TBI) leads to acute coma and may result in prolonged disorder of consciousness (pDOC). We aimed to determine whether right median nerve electrical stimulation is a safe and effective treatment for accelerating emergence from coma after TBI.This randomised controlled trial was performed in 22 centres in China. Participants with acute coma at 7-14 days after TBI were randomly assigned (1:1) to either routine therapy and right median nerve electrical stimulation (RMNS group) or routine treatment (control group). The RMNS group received 20 mA, 300 μs, 40 Hz stimulation pulses, lasting 20 s per minutes, 8 h per day, for 2 weeks. The primary outcome was the proportion of patients who regained consciousness 6 months post-injury. The secondary endpoints were Glasgow Coma Scale (GCS), Full Outline of Unresponsiveness scale (FOUR), Coma Recovery Scale-Revised (CRS-R), Disability Rating Scale (DRS) and Glasgow Outcome Scale Extended (GOSE) scores reported as medians on day 28, 3 months and 6 months after injury, and GCS and FOUR scores on day 1 and day 7 during stimulation. Primary analyses were based on the intention-to-treat set.Between March 26, 2016, and October 18, 2020, 329 participants were recruited, of whom 167 were randomised to the RMNS group and 162 to the control group. At 6 months post-injury, a higher proportion of patients in the RMNS group regained consciousness compared with the control group (72.5%, n = 121, 95% confidence interval (CI) 65.2-78.7% vs. 56.8%, n = 92, 95% CI 49.1-64.2%, p = 0.004). GOSE at 3 months and 6 months (5 [interquartile range (IQR) 3-7] vs. 4 [IQR 2-6], p = 0.002; 6 [IQR 3-7] vs. 4 [IQR 2-7], p = 0.0005) and FOUR at 28 days (15 [IQR 13-16] vs. 13 [interquartile range (IQR) 11-16], p = 0.002) were significantly increased in the RMNS group compared with the control group. Trajectory analysis showed that significantly more patients in the RMNS group had faster GCS, CRS-R and DRS improvement (p = 0.01, 0.004 and 0.04, respectively). Adverse events were similar in both groups. No serious adverse events were associated with the stimulation device.Right median nerve electrical stimulation is a possible effective treatment for patients with acute traumatic coma, that will require validation in a confirmatory trial.© 2023. The Author(s).

基金:
语种:
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2022]版:
大类 | 1 区 医学
小类 | 1 区 危重病医学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 危重病医学
JCR分区:
出版当年[2021]版:
Q1 CRITICAL CARE MEDICINE
最新[2023]版:
Q1 CRITICAL CARE MEDICINE

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者:
第一作者单位: [2]Departmentof Neurosurgery, Shanghai General Hospital, School of Medicine, ShanghaiJiao Tong University, Shanghai, China
共同第一作者:
通讯作者:
通讯机构: [1]Department of Neurosurgery, Beijing Tiantan Hospital, Capital MedicalUniversity, Beijing 100070, People’s Republic of China [2]Departmentof Neurosurgery, Shanghai General Hospital, School of Medicine, ShanghaiJiao Tong University, Shanghai, China [29]Shanghai Institute of HeadTrauma, Shanghai, China
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:432 今日访问量:0 总访问量:412 更新日期:2025-04-01 建议使用谷歌、火狐浏览器 常见问题

版权所有:重庆聚合科技有限公司 渝ICP备12007440号-3 地址:重庆市两江新区泰山大道西段8号坤恩国际商务中心16层(401121)