Interventions pharmacologiques pour le contrôle du délirium et de l'agitation suite à un traumatisme cranio-cérébral : une revue systématique de données cliniques et précliniques

 

David Williamson

Centre de recherche de l'Hôpital du Sacré-Coeur de Montréal

 

Domaine : neurosciences, santé mentale et toxicomanies

Consortium pour le développement de la recherche en traumatologie - volet 4

Concours 2015-2016

Traumatic brain injury (TBI) affects a great numbers of patients in Canada and is responsible for considerable morbidity and mortality. Survivors of TBI often suffer from disorders of consciousness including delirium. Delirium is defined as a state of confusion characterized by a fluctuation in mental state, an attention deficit, disorganized thinking and an alteration in consciousness. Medications are often used by clinicians in these cases in order to control agitation and facilitate rehabilitation. The use of medications if justified by the fact that it is potentially more dangerous to leave the patient confused and agitated without treatment.

However, the most optimal and secure treatment which does not interfere with brain function recovery remains controversial. Animal studies have suggested that certain medications used to treat delirium may hasten the brain's capacity to recover. Still, medications are commonly used to treat delirium and agitation in TBI patients. The objective of this project is to systematically review the existing scientific litterature evaluating the effects of medications in the treatment of delirium in TBI patients, including animal and clinical studies. An exhaustive literature search will be undertaken and the whole of the literature on the subject will be evaluated, analyzed and synthesized. The results of this project will guide the optimal attitudes to adopt in the treatment of delirium and identify research priorities.