Paroxysmal Sympathetic Hyperactivity in Neurocritical Children: A Pilot Study

Jhamb, Urmila; Saxena, Romit; Agrwal, Shipra; Pallavi, FNU

doi:10.5005/jp-journals-10071-24346

Cited by 4 publications

(5 citation statements)

References 26 publications

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“…We read with interest Agrwal et al's article on a study of five pediatric patients with definite and 30 patients with incomplete paroxysmal sympathetic hyperactivity (PSH) syndrome. 1 Patients with definite PSH had a longer duration of mechanical ventilation, a longer PICU stay, and higher PRISMIII scores compared with patients with incomplete PSH. 1 It was concluded that PSH is common in children with neurological diseases admitted to the PICU, and that these children had higher disease severity scores, longer duration of mechanical ventilation, and longer PICU stay than controls.…”

mentioning

confidence: 88%

“… 1 Patients with definite PSH had a longer duration of mechanical ventilation, a longer PICU stay, and higher PRISMIII scores compared with patients with incomplete PSH. 1 It was concluded that PSH is common in children with neurological diseases admitted to the PICU, and that these children had higher disease severity scores, longer duration of mechanical ventilation, and longer PICU stay than controls. 1 The study is excellent, but some points should be discussed.…”

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confidence: 88%

“… 1 It was concluded that PSH is common in children with neurological diseases admitted to the PICU, and that these children had higher disease severity scores, longer duration of mechanical ventilation, and longer PICU stay than controls. 1 The study is excellent, but some points should be discussed.…”

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confidence: 99%

“…There is also a discrepancy between the “Data collection” section and the “Outcome variables” section. 1 In the “Data collection” section, the outcome was defined as “improvement or death” while in the “Outcome variables” section, the primary outcome was defined as “incidence of PSH” and secondary outcome was defined as “association of PSH with mortality and morbidity, such as requirement of mechanical ventilation, length of PICU stay, and ventilation”. 1 This discrepancy should be resolved.…”

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confidence: 99%

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Before Diagnosing Paroxysmal Sympathetic Hyperactivity in PICU Patients Alternative Conditions must be Considered

Finsterer

2024

Indian Journal of Critical Care Medicine

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confidence: 88%

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confidence: 88%

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confidence: 99%

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confidence: 99%

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Before Diagnosing Paroxysmal Sympathetic Hyperactivity in PICU Patients Alternative Conditions must be Considered

Finsterer

2024

Indian Journal of Critical Care Medicine

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“…3 , 4 Among many syndromes associated with secondary brain injury, PSH is a syndrome where episodes of increased sympathetic activity are seen. 5 The incidence of PSH among the patients suffering TBI is between 7.7 and 33%. 3 Early identification of PSH is imperative as it increases morbidity and long-term disability after brain injury.…”

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confidence: 99%

Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study

Kumar,

Azim,

Singh

et al. 2024

Indian Journal of Critical Care Medicine

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A bstract Background Traumatic brain injury (TBI) is a major cause of mortality among young individuals, accounting for 65% of deaths in road traffic accidents. Paroxysmal sympathetic hyperactivity (PSH) is a common syndrome associated with TBI. This study represents the first prospective investigation aimed at assessing the impact of gabapentin on TBI patients, focusing on the prevention of secondary brain injury and brain edema while enhancing the Glasgow Coma Scale (GCS). Materials and methods The study was conducted from September 2019 to July 2021 after receiving ethical committee approval. It included adult ICU patients (≥18 years) with moderate and severe GCS. Patients below 18 years, death within 48 hours, non-consenting, pregnant females, and individuals allergic to gabapentin were excluded from the study. Patients were randomly allocated in two groups: study group received 300 mg of gabapentin orally twice daily and control group received multivitamin tablets twice daily. The treatment period spanned 2 weeks. Follow-up occurred in the ICU and continued for up to 3 months post-discharge, including telephonic conversations. Results About 60 patients were involved for analysis. Significant differences were found in GCS change from admission to discharge, Glasgow Outcome Scale (GOS) at 30 and 90 days, PSH episodes, and sedation bolus per day. Glasgow Coma Scale change was 53% in the study group compared with 25% in the control group ( p = 0.009). Mortality was significantly lower in the study group. Glasgow Outcome Scale change between 30 and 90 days showed a 25% improvement in cases and no change in controls ( p = 0.001). Conclusion This pioneering study underscores the potential of gabapentin in managing traumatic brain injuries. How to cite this article Singh R, Ambasta S, Bais PS, Azim A, Kumar S, Upreti B, et al . Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study. Indian J Crit Care Med 2024;28(2):120–125.

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Paroxysmal Sympathetic Hyperactivity: It is Time to Use the New Diagnostic Criteria

Krupanandan¹

2022

Indian Journal of Critical Care Medicine

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Paroxysmal Sympathetic Hyperactivity in Neurocritical Children: A Pilot Study

Cited by 4 publications

References 26 publications

Before Diagnosing Paroxysmal Sympathetic Hyperactivity in PICU Patients Alternative Conditions must be Considered

Before Diagnosing Paroxysmal Sympathetic Hyperactivity in PICU Patients Alternative Conditions must be Considered

Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study

Paroxysmal Sympathetic Hyperactivity: It is Time to Use the New Diagnostic Criteria

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