Neuroleptic malignant syndrome in traumatic brain injury patients treated with haloperidol.
Neuroleptic malignant syndrome in traumatic brain injury patients treated with haloperidol.
复制标题
氟哌啶醇治疗创伤性脑损伤患者的抗精神病药恶性综合征。
DOI：
10.1097/ta.0b013e31818e90ed
复制
发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Amy L. Seybert
中科院分区：
文献类型：
--
作者：
C. Bellamy;S. Kane‐Gill;B. Falcione;Amy L. Seybert
背景
氟哌啶醇常用于治疗危重患者的激越，与抗精神病药恶性综合征（NMS）的发生有关。本手稿的目的是审查描述NMS和氟哌啶醇用于创伤性脑损伤（TBI）患者的文献，因为这些患者可能有更大的NMS风险。
方法
对MEDLINE进行了计算机检索（1966年至2008年5月），以确定氟哌啶醇与TBI患者NMS相关的所有出版物。对这些手稿的参考文献进行了审查，以获得其他文献。
结果
9份病例报告描述了接受氟哌啶醇治疗激越的TBI患者发生NMS的情况。NMS发作前的累积氟哌啶醇剂量范围为10 mg至至少210 mg。大多数患者接受高剂量（≥ 30 mg）氟哌啶醇治疗。4例患者接受氟哌啶醇胃肠外。确诊NMS后，5例患者停用氟哌啶醇，均给予支持性护理和药物治疗。患者出院时功能有所改善，但功能下降。
结论
在接受氟哌啶醇治疗的TBI患者中发生NMS应引起临床医生的关注，因为这些患者发生该不良事件的风险可能更大;特别是如果患者接受高剂量氟哌啶醇胃肠外给药。需要进一步研究来评估持续TBI并接受氟哌啶醇的患者中不良事件的发生率和增加的风险，特别是因为氟哌啶醇在危重患者中使用得更频繁。
BACKGROUND
Haloperidol, which is commonly used to treat agitation in critically ill patients, has been associated with the development of neuroleptic malignant syndrome (NMS). The purpose of this manuscript was to review the literature describing NMS and haloperidol use in patients sustaining a traumatic brain injury (TBI) since these patients may be at greater risk for NMS.
METHODS
A computerized search of MEDLINE was conducted (1966-May 2008) to identify all publications in which haloperidol was related to NMS in patients with a TBI. The references of these manuscripts were reviewed for additional literature.
RESULTS
Nine case reports describe the development of NMS in patients with TBI treated with haloperidol for agitation. Cumulative haloperidol doses before the onset of NMS ranged from 10 mg to at least 210 mg. Most of these patients received high dose (> or =30 mg) haloperidol. Four patients received haloperidol parenterally. On diagnosis, of NMS, haloperidol was discontinued in five cases, and all were given supportive care and pharmacologic treatment. Patients were discharged with improved, but diminished functional capacity.
CONCLUSION
Development of NMS in TBI patients treated with haloperidol should be a concern for clinicians since these patients may be at greater risk for this adverse event; especially if the patient is receiving haloperidol at high doses parenterally. Future studies are needed to evaluate the incidence and increased risk of adverse events in patients sustaining a TBI and receiving haloperidol especially since haloperidol is being used more frequently in the critically ill patients.
影响因子：
--
作者：
KeckJr,PE;PopeJr,HG;Cohen,BM;McElroy,SL;Nierenberg,AA
通讯作者：
Nierenberg,AA