Laporan kasus berbasis bukti: Efektifitas Pemberian Calcium Channel Blocker pada Perdarahan Subaraknoid Akibat Trauma Kepala

Irawan Mangunatmadja, Anton Dharma Saputra

Sari


Latar belakang. Efektifitas pemberian calcium channel blocker (CCB) pada pasien trauma kepala dengan perdarahan subaraknoid masih kontroversial.
Tujuan. Melakukan telaah kritis untuk melihat efektifitas CCB pada perdarahan subaraknoid.
Metode. Pencarian artikel dilakukan secara daring menggunakan instrumen kata kunci yang sesuai melalui basis data New England journal of medicine (NEJM), Pubmed dan Cochrane pada bulan Mei-Juli 2019.
Hasil. Didapatkan 2 artikel berupa studi meta-analisis dan laporan kasus. Hasil analisis sub-kelompok tSAH pada meta-analisis, tingkat kematian 23% pada kelompok uji dan 32% pada kelompok plasebo, tetapi perbedaan ini tidak bermakna secara statistik. Hasil studi kasus serial pemberian nimodipine oral pada pasien anak dengan perdarahan subaraknoid tidak mengurangi kejadian vasospasme serebral, ataupun infark.
Kesimpulan. Penggunaan nimodipin pada kasus perdarahan subaraknoid akibat trauma kepala masih dapat dipertimbangkan. 


Kata Kunci


Nimodipine; perdarahan subaraknoid; CCB; calcium channel blocker

Teks Lengkap:

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Referensi


Langham J, Goldfrad C, Teasdale G, Shaw D, Rowan K. Calcium channel blockers for acute traumatic brain injury. Cochrane Database Syst Rev. 2003.

Vergouwen MD, Vermeulen M, Roos Y. Effect of nimodipine on outcome in patients with traumatic subarachnoid haemorrhage: a systematic review. Lancet Neurol 2006;5:1029-32.

Xu GZ, Wang MD, Liu KG, Bai YA, Wu W, Li W. A meta-analysis of treating acute traumatic brain injury with calcium channel blockers. Brain Res Bull 2013;99:41-7.

Compton JS, Lee T, Jones NR, Waddell G, Teddy PJ. A double blind placebo controlled trial of the calcium entry blocking drug, nicardipine, in the treatment of vasospasm following severe head injury. Br J Neurosurg 1990;4:9-15.

Sahuquillo J, Robles A, Poca A, Ballabriga A, Mercadal J, Secades JJ. A controlled, double-blind, randomized pilot clinical trial of nicardipine as compared with a placebo in patients with moderate or severe head injury. Rev Neurol 2000;30:401-8.

Bailey I, Bell A, Gray J, Gullan R, Heiskanan O, Marks PV, dkk. A trial of the effect of nimodipine on outcome after head injury. Acta Neurochir (Wien) 1991;110:97-105.

Farhoudi M, Asghari M, Aghajanloo M, Zeinali A. Effects of nimodipine on cerebral hemodynamics, and prognosis of diffuse axonal injury patients. Neurosciences (Riyadh) 2007;12:285-8.

Feng D, Ma Y, Zhang Y, Plets C, Goffin J, Chen J. Controlled study of nimodipine in treatment of patients with diffuse axonal injury. Chin J Traumatol 2000;3:85-8.

European Study Group on Nimodipine in Severe Head Injury. A multicenter trial of the efficacy of nimodipine on outcome after severe head injury. J Neurosurg 1994;80:797-804.

Teasdale G, Bailey I, Bell A, dkk. A randomized trial of nimodipine in severe head injury: HIT I. British/Finnish Co-operative Head Injury Trial Group. J Neurotrauma 1992;9:545-50.

Harders A, Kakarieka A, Braakman R. Traumatic subarachnoid hemorrhage and its treatment with nimodipine. J Neurosurg 1996;85:82-9.

Kostron H, Rumpl E, Stampfl G, Russegger L, Grunert V. Treatment of cerebral vasospasm following severe head injury with the calcium influx blocker nimodipine. Neurochirurgia (Stuttg) 1985;28:103-9.

Murray GD, Teasdale GM, Schmitz H. Nimodipine in traumatic subarachnoid haemorrhage: a re-analysis of the HIT I and HIT II trials. Acta Neurochir (Wien) 1996;138:1163-7.

Heffren J, Mcintosh AM, Reiter PD. Nimodipine for the prevention of cerebral vasospasm following subarachnoid haemorrhage in twelve children. Pediatr Neurol 2015;52:356-60.

Nicholls DG, Budd SL. Mitochondria and neuronal survival. Physiol Rev 2000;80:315-60.




DOI: http://dx.doi.org/10.14238/sp22.4.2020.243-51

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