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Volume 3 Supplement 1

ESICM LIVES 2015

Dopaminergic Challenge With Bromocriptine in Patients With Severe Brain Injury

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Introduction

Bromocriptine Mesylate (BC) is an ergot derivative with potent dopamine receptor agonist activity. It is licensed to reduce plasma levels of prolactin. BC has central nervous effects, and is used in patients with Parkinson's disease. There are few randomized controlled trials with BC conducted in moderate brain injury (BI) with conflicting results (1). We aim to present our single center experience on dopaminergic challenge using off-label BC in patients with severe BI.

Methods

Glasgow Coma Score (GCS) are 3-10 (GCS: worst score = 3, best score = 15) at beginning of BC administration. Patients received 2.5mg of BC q6h after hemodynamic stability was ensured and no further neurologic improvement was observed during course of management. BC was started and discontinued on the discretion of the ICU team. Long term cognitive tests are under assessment.

Results

A total of 18 patients were treated with BC. the average age was 48.9 (82-18) (12M/6F).

Conclusions

Our results show some neurologic improvement as assessed by GCS. More research is warranted before BC can be recommended in BI.

Table 1 GCS of patients on admission, beginning treatment, end of treatment and discharge. GCS of patients on admission, beginning treatment.

References

  1. 1.

    Frenette AJ, Kanji S, Rees L, Williamson DR, Perreault MM, Turgeon AF, et al: Efficacy and safety of dopamine agonists in traumatic brain injury: a systematic review of randomized controlled trials. J Neurotrauma. 2012, 29 (1): 1-18. 10.1089/neu.2011.1812.

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Author information

Correspondence to JB Celik.

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Keywords

  • Brain Injury
  • Prolactin
  • Bromocriptine
  • Glasgow Coma Score
  • Single Center Experience